C4A.0
C4A.0: Merkel cell carcinoma of lip
Billable / specific codeICD-10-CM
C4A.0 is a billable, specific ICD-10-CM code for merkel cell carcinoma of lip. It is valid for submission on a claim.
Check C4A.0 with the rest of the claim: free scrubberOther codes that can never be billed with C4A.0
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
C4A.0 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 21 Lymphoma and Other Cancers0.671 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
C4A.0 is named in 51 Medicare coverage policies: 51 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52479Oral Anticancer Drugs - Policy Article
- A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
- A53883Billing and Coding: Mohs Micrographic Surgery (MMS)
- A54768Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy
Alphabetic index entries that lead here
- Carcinoma›Merkel cell›lip
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under C4A
- C4A.1Merkel cell carcinoma of eyelid, including canthus
- C4A.2Merkel cell carcinoma of ear and external auricular canal
- C4A.3Merkel cell carcinoma of other and unspecified parts of face
- C4A.4Merkel cell carcinoma of scalp and neck
- C4A.5Merkel cell carcinoma of trunk
- C4A.6Merkel cell carcinoma of upper limb, including shoulder
- C4A.7Merkel cell carcinoma of lower limb, including hip
- C4A.8Merkel cell carcinoma of overlapping sites
- C4A.9Merkel cell carcinoma, unspecified