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ICD-10 Guide
ICD-10 CodesC44.1091

C44.1091

Billable

Unspecified malignant neoplasm of skin of left upper eyelid, including canthus

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

Code Description

ICD-10 C44.1091 is a billable code used to indicate a diagnosis of unspecified malignant neoplasm of skin of left upper eyelid, including canthus.

Key Diagnostic Point:

C44.1091 refers to an unspecified malignant neoplasm of the skin located on the left upper eyelid, including the canthus. This type of skin cancer can arise from various skin cells and may present as a lesion that is asymptomatic or may cause symptoms such as irritation or changes in appearance. The eyelid is a common site for skin cancers, particularly in individuals with significant sun exposure, as ultraviolet (UV) radiation is a major risk factor. Surgical intervention is often required for treatment, which may involve excision of the tumor along with a margin of healthy tissue to ensure complete removal. Reconstruction of the eyelid may be necessary post-surgery to restore function and aesthetics, given the delicate nature of the eyelid structure. Accurate coding is essential for proper treatment planning and reimbursement, as well as for tracking the incidence of skin cancers in this area.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of tumor type and characteristics
  • Need for precise anatomical localization
  • Potential for multiple surgical procedures and reconstruction
  • Differentiation from benign lesions

Audit Risk Factors

  • Inadequate documentation of tumor characteristics
  • Failure to document surgical margins
  • Lack of clarity on the extent of the neoplasm
  • Improper coding of reconstructive procedures

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

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

Common Clinical Scenarios

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

Billing Considerations

Ensure clear documentation of margins and any reconstructive procedures performed.

Ophthalmology

Documentation Requirements

Documentation of visual function, eyelid anatomy, and any associated ocular symptoms.

Common Clinical Scenarios

Management of eyelid tumors and reconstruction post-excision.

Billing Considerations

Focus on the functional impact of the neoplasm on vision and eyelid movement.

Coding Guidelines

Inclusion Criteria

Use C44.1091 When
  • Follow ICD
  • CM guidelines for coding neoplasms, ensuring accurate documentation of the site, laterality, and type of neoplasm
  • Include any relevant surgical procedures and modifiers as necessary

Exclusion Criteria

Do NOT use C44.1091 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

11420CPT Code

Excision, malignant skin lesion

Clinical Scenario

Used when excising a malignant neoplasm from the left upper eyelid.

Documentation Requirements

Document size, location, and type of lesion excised.

Specialty Considerations

Ensure that the procedure is performed by a qualified specialist, such as a dermatologist or ophthalmologist.

67904CPT Code

Repair of eyelid

Clinical Scenario

Used for reconstructive surgery following excision of the malignant neoplasm.

Documentation Requirements

Document the extent of reconstruction and any complications.

Specialty Considerations

Consider the functional and aesthetic outcomes in documentation.

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, improving the accuracy of data collection and reimbursement processes. C44.1091 provides a clear designation for malignant neoplasms of the eyelid, which was less specific in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of skin cancers, improving the accuracy of data collection and reimbursement processes. C44.1091 provides a clear designation for malignant neoplasms of the eyelid, which was less specific in ICD-9.

Reimbursement & Billing Impact

reimbursement processes. C44.1091 provides a clear designation for malignant neoplasms of the eyelid, which was less specific in ICD-9.

Resources

Clinical References

  • •
    American Academy of Dermatology
  • •
    American Academy of Ophthalmology

Coding & Billing References

  • •
    American Academy of Dermatology
  • •
    American Academy of Ophthalmology

Frequently Asked Questions

What is the significance of specifying the eyelid in the diagnosis?

Specifying the eyelid is crucial for treatment planning and determining the appropriate surgical approach, as the eyelid's anatomy is complex and requires careful consideration during excision and reconstruction.

How does sun exposure relate to this diagnosis?

Sun exposure is a major risk factor for skin cancers, including those on the eyelids. Patients with significant UV exposure history are at higher risk for developing malignant neoplasms in this area.