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ICD-10 Guide
ICD-10 CodesC44.1291

C44.1291

Billable

Squamous cell carcinoma of skin of left upper eyelid, including canthus

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

Code Description

ICD-10 C44.1291 is a billable code used to indicate a diagnosis of squamous cell carcinoma of skin of left upper eyelid, including canthus.

Key Diagnostic Point:

Squamous cell carcinoma (SCC) of the skin is a malignant tumor that arises from the squamous cells, which are flat cells located in the outer layer of the skin. The left upper eyelid, including the canthus, is a common site for this type of skin cancer, often due to prolonged sun exposure. SCC can present as a persistent, non-healing sore, a scaly patch, or a growth that may bleed or crust. Risk factors include fair skin, history of sunburns, and immunosuppression. Surgical excision is the primary treatment, and it is crucial to achieve clear surgical margins to minimize recurrence. Reconstruction may be necessary depending on the extent of the excision, particularly in cosmetically sensitive areas like the eyelid. Post-operative care and monitoring for recurrence are essential components of management, as SCC can metastasize if not adequately treated.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Specificity of the anatomical location (left upper eyelid, including canthus)
  • Need for clear documentation of surgical margins
  • Potential for reconstruction procedures post-excision
  • Differentiation from other skin cancers (e.g., basal cell carcinoma)

Audit Risk Factors

  • Inadequate documentation of surgical margins
  • Failure to document the specific location of the carcinoma
  • Lack of follow-up care documentation
  • Inconsistent coding of related procedures (e.g., reconstruction)

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

Detailed clinical notes on the lesion's characteristics, size, and location, as well as treatment plans.

Common Clinical Scenarios

Diagnosis and treatment of skin lesions, management of skin cancer, and post-operative care.

Billing Considerations

Ensure clear documentation of the surgical margins and any reconstruction performed.

Ophthalmology

Documentation Requirements

Documentation of visual function, eyelid anatomy, and any impact on ocular health.

Common Clinical Scenarios

Management of eyelid tumors, surgical interventions, and cosmetic considerations.

Billing Considerations

Coordination with dermatology for comprehensive care and accurate coding.

Coding Guidelines

Inclusion Criteria

Use C44.1291 When
  • Follow the official ICD
  • CM guidelines for coding neoplasms, ensuring accurate documentation of the site and type of cancer
  • Include any relevant surgical procedures and follow
  • up care in the coding process

Exclusion Criteria

Do NOT use C44.1291 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

11600CPT Code

Excision, malignant skin lesion, face, ears, eyelids

Clinical Scenario

Used when excising SCC from the left upper eyelid.

Documentation Requirements

Document the size of the lesion and margins achieved.

Specialty Considerations

Ensure coordination between dermatology and ophthalmology for comprehensive care.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 allows for more specific coding of skin cancers, improving data accuracy and facilitating better patient management.

ICD-9 vs ICD-10

The transition to ICD-10 allows for more specific coding of skin cancers, improving data accuracy and facilitating better patient management.

Reimbursement & Billing Impact

The transition to ICD-10 allows for more specific coding of skin cancers, improving data accuracy and facilitating better patient management.

Resources

Clinical References

  • •
    American Academy of Dermatology
  • •
    National Comprehensive Cancer Network (NCCN)

Coding & Billing References

  • •
    American Academy of Dermatology
  • •
    National Comprehensive Cancer Network (NCCN)

Frequently Asked Questions

What is the significance of documenting surgical margins?

Documenting surgical margins is crucial to ensure that the cancer has been completely excised, reducing the risk of recurrence and supporting the medical necessity of the procedure.