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ICD-10 Guide
ICD-10 CodesC44.1321

C44.1321

Billable

Sebaceous cell carcinoma of skin of right upper eyelid, including canthus

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

Code Description

ICD-10 C44.1321 is a billable code used to indicate a diagnosis of sebaceous cell carcinoma of skin of right upper eyelid, including canthus.

Key Diagnostic Point:

Sebaceous cell carcinoma is a rare and aggressive form of skin cancer that arises from sebaceous glands, which are responsible for producing oil that lubricates the skin and hair. This specific code pertains to the carcinoma located on the right upper eyelid, including the canthus, which is the corner of the eye where the upper and lower eyelids meet. Patients with sebaceous cell carcinoma may present with a painless, firm nodule that can be mistaken for a benign lesion. Risk factors include chronic sun exposure, which can lead to DNA damage in skin cells, and a history of skin cancer. Surgical excision is the primary treatment, and due to the delicate nature of eyelid anatomy, achieving clear surgical margins is critical to prevent recurrence. Reconstruction may be necessary post-excision to restore eyelid function and appearance, often involving techniques such as skin grafts or local flaps. Regular follow-up is essential for monitoring potential recurrence, as sebaceous cell carcinoma can metastasize if not adequately treated.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Specificity of the anatomical location (right upper eyelid, including canthus)
  • Need for clear documentation of surgical margins
  • Potential for reconstruction procedures post-excision
  • Differentiation from other skin cancers

Audit Risk Factors

  • Inadequate documentation of surgical margins
  • Failure to specify the exact location of the carcinoma
  • Misclassification of the type of skin cancer
  • Lack of follow-up documentation post-surgery

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

Detailed clinical notes including lesion size, location, and histopathology results.

Common Clinical Scenarios

Diagnosis and treatment of skin cancers, including excision and reconstruction.

Billing Considerations

Ensure accurate coding of the type of skin cancer and any associated procedures.

Oculoplastic Surgery

Documentation Requirements

Surgical reports detailing the excision and reconstruction techniques used.

Common Clinical Scenarios

Reconstruction of eyelid defects post-excision of skin cancers.

Billing Considerations

Documentation must reflect the complexity of eyelid anatomy and the need for cosmetic and functional restoration.

Coding Guidelines

Inclusion Criteria

Use C44.1321 When
  • Follow the official ICD
  • CM coding guidelines for neoplasms, ensuring accurate documentation of the site, laterality, and type of carcinoma
  • Include any relevant surgical procedures in the coding

Exclusion Criteria

Do NOT use C44.1321 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

11600CPT Code

Excision, malignant skin lesion, face, ears, eyelids, scalp

Clinical Scenario

Used when excising the sebaceous cell carcinoma from the eyelid.

Documentation Requirements

Document the size of the lesion and the margins obtained.

Specialty Considerations

Ensure that the excision is performed by a qualified specialist.

67904CPT Code

Repair of eyelid defect

Clinical Scenario

Used for reconstructive surgery following excision.

Documentation Requirements

Document the technique used for reconstruction.

Specialty Considerations

Detail the complexity of the repair in the surgical report.

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. C44.1321 provides detailed information about the location and type of carcinoma, which is essential for treatment planning and follow-up.

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. C44.1321 provides detailed information about the location and type of carcinoma, which is essential for treatment planning and follow-up.

Reimbursement & Billing Impact

reimbursement processes. C44.1321 provides detailed information about the location and type of carcinoma, which is essential for treatment planning and follow-up.

Resources

Clinical References

  • •
    American Academy of Dermatology
  • •
    National Comprehensive Cancer Network

Coding & Billing References

  • •
    American Academy of Dermatology
  • •
    National Comprehensive Cancer Network

Frequently Asked Questions

What is sebaceous cell carcinoma?

Sebaceous cell carcinoma is a rare skin cancer that originates from sebaceous glands, often presenting as a firm nodule on the skin. It is more aggressive than other skin cancers and requires careful treatment and follow-up.

How is sebaceous cell carcinoma treated?

Treatment typically involves surgical excision with clear margins, and reconstruction may be necessary to restore eyelid function and appearance. Regular follow-up is crucial to monitor for recurrence.