C4A.51

C4A.51: Merkel cell carcinoma of anal skin

Billable / specific codeICD-10-CM

C4A.51 is a billable, specific ICD-10-CM code for merkel cell carcinoma of anal skin. It is valid for submission on a claim.

Check C4A.51 with the rest of the claim: free scrubber

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Merkel cell carcinoma of anal margin
Merkel cell carcinoma of perianal skin

Excludes2 inherited from the categories above C4A.51

Not part of this code, but both may be coded when both are present.

Written on C4A.5: Merkel cell carcinoma of trunk

malignant neoplasm of anus NOS (C21.0)
malignant neoplasm of scrotum (C63.2)

Other codes that can never be billed with C4A.51

Their own Excludes1 notes name this code, so the conflict is not listed above.

C44Other and unspecified malignant neoplasm of skin

Risk adjustment

C4A.51 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.51 is named in 47 Medicare coverage policies: 47 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
A54768Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy
A56421Billing and Coding: CT of the Abdomen and Pelvis