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ICD-10 Guide
ICD-10 CodesC44.49

C44.49

Billable

Other specified malignant neoplasm of skin of scalp and neck

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

Code Description

ICD-10 C44.49 is a billable code used to indicate a diagnosis of other specified malignant neoplasm of skin of scalp and neck.

Key Diagnostic Point:

C44.49 refers to malignant neoplasms of the skin located on the scalp and neck that do not fall into more specific categories. This code encompasses various types of skin cancers, including those that may arise from atypical melanocytes or keratinocytes. Skin cancers in these areas are often influenced by sun exposure, which is a significant risk factor due to the high UV radiation levels that can lead to DNA damage in skin cells. Surgical management typically involves excision of the tumor with clear margins to ensure complete removal and minimize recurrence. Reconstruction may be necessary depending on the size and location of the excised lesion, particularly in cosmetically sensitive areas like the face and scalp. The complexity of treatment and coding can vary based on the histological type of the malignancy, the extent of the disease, and the surgical techniques employed. Accurate coding is essential for proper reimbursement and to reflect the severity of the condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of histological types of skin cancers
  • Need for precise documentation of surgical margins
  • Variability in reconstruction techniques
  • Potential for multiple malignancies in the same area

Audit Risk Factors

  • Inadequate documentation of surgical margins
  • Failure to specify the type of malignant neoplasm
  • Lack of clarity on the extent of excision and reconstruction
  • Misclassification of benign lesions as malignant

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

Detailed pathology reports, surgical notes, and follow-up care documentation.

Common Clinical Scenarios

Diagnosis and treatment of basal cell carcinoma, squamous cell carcinoma, and melanoma on the scalp and neck.

Billing Considerations

Ensure clear documentation of margins and any reconstructive procedures performed.

Oncology

Documentation Requirements

Comprehensive treatment plans, staging information, and follow-up assessments.

Common Clinical Scenarios

Management of advanced skin cancers requiring chemotherapy or radiation therapy.

Billing Considerations

Document any systemic treatments and their effects on the malignancy.

Coding Guidelines

Inclusion Criteria

Use C44.49 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only when the malignancy is confirmed by histopathological examination

Exclusion Criteria

Do NOT use C44.49 When
  • Exclude codes for benign lesions and ensure that the documentation supports the diagnosis

Related ICD-10 Codes

Related CPT Codes

11600CPT Code

Excision, malignant skin lesion

Clinical Scenario

Used when excising a malignant neoplasm from the scalp or neck.

Documentation Requirements

Surgical notes detailing the size of the lesion and margins.

Specialty Considerations

Dermatologists should document the type of malignancy and any reconstruction performed.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of skin malignancies, improving the accuracy of data collection and reimbursement processes. C44.49 provides a distinct code for other specified malignant neoplasms, which aids in tracking treatment outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of skin malignancies, improving the accuracy of data collection and reimbursement processes. C44.49 provides a distinct code for other specified malignant neoplasms, which aids in tracking treatment outcomes and resource allocation.

Reimbursement & Billing Impact

reimbursement processes. C44.49 provides a distinct code for other specified malignant neoplasms, which aids in tracking treatment outcomes and resource allocation.

Resources

Clinical References

  • •
    American Academy of Dermatology
  • •
    National Cancer Institute

Coding & Billing References

  • •
    American Academy of Dermatology
  • •
    National Cancer Institute

Frequently Asked Questions

What types of skin cancers are included under C44.49?

C44.49 includes various malignant neoplasms of the skin on the scalp and neck that are not classified elsewhere, such as atypical melanomas and other specified skin cancers.

How do I document surgical margins for C44.49?

Document the size of the excised lesion, the margins obtained, and any additional reconstructive procedures performed to ensure accurate coding.