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ICD-10 Guide
ICD-10 CodesC44.1222

C44.1222

Billable

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

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

Code Description

ICD-10 C44.1222 is a billable code used to indicate a diagnosis of squamous cell carcinoma of skin of right lower 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. This specific code, C44.1222, refers to SCC located on the right 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, making it more prevalent in individuals with fair skin or those who have had significant UV exposure. The clinical presentation may include a persistent sore, a growth that bleeds or crusts, or a scaly patch that does not heal. Surgical excision is the primary treatment, and it is crucial to ensure clear surgical margins to prevent recurrence. Reconstruction may be necessary depending on the extent of the excision, particularly in cosmetically sensitive areas like the eyelids. The prognosis is generally favorable with early detection and appropriate treatment, but careful monitoring is essential due to the risk of metastasis in more advanced cases.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

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

Audit Risk Factors

  • Inadequate documentation of tumor size and margins
  • Failure to specify the location accurately
  • Lack of clarity on the type of surgical procedure performed
  • Inconsistent coding of associated reconstruction 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 SCC and basal cell carcinoma.

Billing Considerations

Ensure accurate coding of margins and any reconstructive procedures performed.

Ophthalmology

Documentation Requirements

Documentation of visual acuity, eyelid function, and any ocular involvement.

Common Clinical Scenarios

Management of eyelid tumors and reconstruction post-excision.

Billing Considerations

Coordination with dermatology for comprehensive care and accurate coding.

Coding Guidelines

Inclusion Criteria

Use C44.1222 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 document the necessity for reconstruction if applicable

Exclusion Criteria

Do NOT use C44.1222 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

17311CPT Code

Excision, malignant skin lesion

Clinical Scenario

Used when excising a squamous cell carcinoma from the eyelid.

Documentation Requirements

Document the size of the lesion and margins obtained.

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 has allowed for greater specificity in coding skin cancers, including the ability to specify the exact location and type of cancer, which aids in better tracking and treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding skin cancers, including the ability to specify the exact location and type of cancer, which aids in better tracking and treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding skin cancers, including the ability to specify the exact location and type of cancer, which aids in better tracking and treatment outcomes.

Resources

Clinical References

  • •
    American Academy of Dermatology

Coding & Billing References

  • •
    American Academy of Dermatology

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 ensuring appropriate follow-up care.