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ICD-10 Guide
ICD-10 CodesC44.1292

C44.1292

Billable

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

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

Code Description

ICD-10 C44.1292 is a billable code used to indicate a diagnosis of squamous cell carcinoma of skin of left lower eyelid, including canthus.

Key Diagnostic Point:

Squamous cell carcinoma (SCC) is a common form of skin cancer that arises from the squamous cells in the epidermis. This specific code, C44.1292, refers to SCC located on the left lower eyelid, including the canthus, which is the corner of the eye where the upper and lower eyelids meet. SCC is often associated with prolonged sun exposure, particularly in fair-skinned individuals, and can present as a persistent, non-healing sore, a scaly patch, or a growth that may bleed or crust. The eyelid area is particularly sensitive and requires careful evaluation due to the potential for cosmetic and functional impairment. Surgical excision is the primary treatment, and achieving clear surgical margins is crucial to prevent recurrence. Reconstruction may be necessary depending on the extent of the excision, and techniques can vary from simple closure to more complex flap procedures. Proper documentation of the tumor size, location, and surgical margins is essential for accurate coding and billing.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Specificity of the location (left lower eyelid, including canthus)
  • Need for detailed documentation of surgical margins
  • Potential for reconstruction procedures post-excision
  • Variability in clinical presentation and treatment approaches

Audit Risk Factors

  • Inadequate documentation of surgical margins
  • Failure to specify the exact location of the carcinoma
  • Lack of clarity on the type of reconstruction performed
  • Misclassification of the cancer type (e.g., confusing SCC with basal cell carcinoma)

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

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

Common Clinical Scenarios

Diagnosis and treatment of skin cancers, including SCC and BCC, and management of post-surgical care.

Billing Considerations

Ensure accurate documentation of margins and any reconstruction performed to support coding.

Ophthalmology

Documentation Requirements

Comprehensive eye examination findings, including visual acuity and eyelid function post-surgery.

Common Clinical Scenarios

Management of eyelid tumors, including excision and reconstruction, and monitoring for recurrence.

Billing Considerations

Document any functional impairments or cosmetic concerns related to eyelid surgery.

Coding Guidelines

Inclusion Criteria

Use C44.1292 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code accurately reflects the diagnosis and location
  • Include any relevant modifiers for surgical procedures and ensure that documentation supports the diagnosis and treatment provided

Exclusion Criteria

Do NOT use C44.1292 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

11600CPT Code

Excision, malignant skin lesion, face, ears, scalp

Clinical Scenario

Used when excising SCC from the left lower eyelid.

Documentation Requirements

Document the size of the lesion and margins.

Specialty Considerations

Dermatologists and ophthalmologists should ensure accurate coding based on the surgical approach.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding skin cancers, including SCC of the eyelid. This specificity aids in better tracking of treatment outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding skin cancers, including SCC of the eyelid. This specificity aids in better tracking of treatment outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding skin cancers, including SCC of the eyelid. This specificity aids in better tracking of treatment outcomes and resource allocation.

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 clear surgical margins in coding C44.1292?

Clear surgical margins indicate that the cancer has been completely excised, which is crucial for preventing recurrence. Documentation of margins is essential for accurate coding and billing.

How does sun exposure relate to C44.1292?

Sun exposure is a significant risk factor for developing squamous cell carcinoma, particularly in areas like the eyelids. Proper documentation of the patient's sun exposure history can support the diagnosis.