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ICD-10 Guide
ICD-10 CodesC44.09

C44.09

Billable

Other specified malignant neoplasm of skin of lip

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 C44.09 is a billable code used to indicate a diagnosis of other specified malignant neoplasm of skin of lip.

Key Diagnostic Point:

C44.09 refers to a malignant neoplasm of the skin located on the lip that does not fall under more specific categories such as basal cell carcinoma or squamous cell carcinoma. These neoplasms can arise from various skin cells and may present as lesions that are often asymptomatic in the early stages. Risk factors include prolonged sun exposure, which can lead to DNA damage in skin cells, increasing the likelihood of malignant transformation. Surgical intervention is typically required for treatment, with the goal of complete excision of the tumor while ensuring adequate surgical margins to prevent recurrence. Reconstruction may be necessary depending on the size and location of the excised lesion, particularly in cosmetic-sensitive areas like the lip. The prognosis is generally favorable if detected early, but careful monitoring is essential due to the potential for metastasis in more aggressive forms of skin cancer.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of tumor type and location
  • Need for precise surgical margin descriptions
  • Differentiation from benign lesions
  • Potential for multiple neoplasms requiring coding

Audit Risk Factors

  • Inadequate documentation of tumor characteristics
  • Failure to document surgical margins
  • Misclassification of neoplasm type
  • Lack of follow-up documentation

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

Detailed descriptions of the lesion, including size, location, and histological type.

Common Clinical Scenarios

Diagnosis and treatment of skin cancers, including Mohs micrographic surgery.

Billing Considerations

Ensure accurate coding of surgical margins and any reconstructive procedures performed.

Oncology

Documentation Requirements

Comprehensive treatment plans, including chemotherapy or radiation therapy if applicable.

Common Clinical Scenarios

Management of advanced skin cancers and coordination of multidisciplinary care.

Billing Considerations

Documentation of staging and follow-up care is crucial for accurate coding.

Coding Guidelines

Inclusion Criteria

Use C44.09 When
  • According to the ICD
  • CM coding guidelines, C44
  • 09 should be used when a malignant neoplasm of the skin of the lip is specified but does not fit into more defined categories
  • Coders must ensure that the diagnosis is confirmed through pathology reports and that all relevant clinical information is documented

Exclusion Criteria

Do NOT use C44.09 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

17311CPT Code

Mohs micrographic surgery, first stage

Clinical Scenario

Used for excision of malignant neoplasm of the lip.

Documentation Requirements

Pathology report confirming malignancy and details of the surgical procedure.

Specialty Considerations

Dermatology and oncology must coordinate on documentation for accurate coding.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of skin cancers, including C44.09, which helps in tracking and managing skin cancer cases more effectively. This specificity aids in research and treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of skin cancers, including C44.09, which helps in tracking and managing skin cancer cases more effectively. This specificity aids in research and treatment outcomes.

Reimbursement & Billing Impact

reimbursement and compliance.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the difference between C44.09 and C44.01?

C44.09 is used for other specified malignant neoplasms of the skin of the lip, while C44.01 specifically refers to basal cell carcinoma of the skin of the lip. Accurate coding depends on the histological type of the neoplasm.