C43.61
C43.61 — Malignant melanoma of right upper limb, including shoulder
Billable / specific codeICD-10-CMright
C43.61 is a billable, specific ICD-10-CM code for malignant melanoma of right upper limb, including shoulder. It is valid for submission on a claim.
Risk adjustment
C43.61 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 23 Prostate, Breast, and Other Cancers and Tumors0.186 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
C43.61 is named in 84 Medicare coverage policies — 84 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
- A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
- A52479Oral Anticancer Drugs - Policy Article
- A52479Oral Anticancer Drugs - Policy Article
Related codes at this level
Codes that share C43.6. If C43.61 is not quite right, the correct code is usually one of these.
Questions about C43.61
- Is C43.61 a billable ICD-10-CM code?
- Yes. C43.61 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does C43.61 sit in the tabular list?
- Neoplasms (C00-D49), in the block Melanoma and other malignant neoplasms of skin (C43-C44).