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ICD-10 Guide
ICD-10 CodesC44.11

C44.11

Billable

Basal cell carcinoma of skin of eyelid, including canthus

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

Code Description

ICD-10 C44.11 is a billable code used to indicate a diagnosis of basal cell carcinoma of skin of eyelid, including canthus.

Key Diagnostic Point:

Basal cell carcinoma (BCC) is the most common form of skin cancer, arising from the basal cells in the epidermis. When located on the eyelid, including the canthus, it poses unique challenges due to the delicate nature of the surrounding structures. BCC is often associated with prolonged sun exposure, particularly in fair-skinned individuals, and can manifest as a pearly nodule, ulceration, or a non-healing sore. The eyelid's thin skin and proximity to the eye necessitate careful surgical intervention to ensure complete excision while preserving function and aesthetics. Surgical margins are critical; a minimum of 4-5 mm is typically recommended to reduce recurrence risk. Reconstruction may involve local flaps or grafts, depending on the size and location of the excised lesion. Accurate coding for BCC of the eyelid is essential for appropriate treatment planning and reimbursement, as it reflects the complexity of the case and the need for specialized surgical techniques.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Location-specific coding due to the eyelid's anatomical complexity.
  • Need for precise documentation of surgical margins.
  • Variability in reconstruction techniques based on tumor size and location.
  • Differentiation from other skin cancers and benign lesions.

Audit Risk Factors

  • Inadequate documentation of surgical margins.
  • Failure to specify the eyelid location (upper vs. lower).
  • Misclassification of the tumor type (e.g., confusing BCC with squamous cell carcinoma).
  • Lack of follow-up documentation for recurrence.

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

Detailed descriptions of the lesion, surgical margins, and reconstruction techniques.

Common Clinical Scenarios

Diagnosis and treatment of BCC on the eyelid, Mohs micrographic surgery.

Billing Considerations

Ensure clear documentation of the surgical approach and any complications.

Ophthalmology

Documentation Requirements

Assessment of eyelid function post-surgery and any visual implications.

Common Clinical Scenarios

Management of eyelid tumors affecting vision or eyelid closure.

Billing Considerations

Coordination with dermatology for comprehensive care.

Coding Guidelines

Inclusion Criteria

Use C44.11 When
  • Follow ICD
  • CM guidelines for coding skin cancers, ensuring specificity in location and type
  • Include documentation of the surgical approach and any reconstruction performed

Exclusion Criteria

Do NOT use C44.11 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

17311CPT Code

Mohs micrographic surgery

Clinical Scenario

Used for excision of BCC on the eyelid.

Documentation Requirements

Document the extent of excision and reconstruction details.

Specialty Considerations

Dermatology and ophthalmology collaboration for eyelid reconstruction.

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 BCC of the eyelid, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of skin cancers, including BCC of the eyelid, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    American Academy of Dermatology

Coding & Billing References

  • •
    American Academy of Dermatology

Frequently Asked Questions

What is the primary cause of basal cell carcinoma?

The primary cause of basal cell carcinoma is prolonged exposure to ultraviolet (UV) radiation from the sun or tanning beds.