C4A.111
C4A.111: Merkel cell carcinoma of right upper eyelid, including canthus
Billable / specific codeICD-10-CMright
C4A.111 is a billable, specific ICD-10-CM code for merkel cell carcinoma of right upper eyelid, including canthus. It is valid for submission on a claim.
Check C4A.111 with the rest of the claim: free scrubberOther codes that can never be billed with C4A.111
Their own Excludes1 notes name this code, so the conflict is not listed above.
- C44Other and unspecified malignant neoplasm of skin
Risk adjustment
C4A.111 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.111 is named in 57 Medicare coverage policies: 57 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
Code history
Unchanged in every release from FY2024 to FY2027.