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ICD-10 Guide
ICD-10 CodesC44.511

C44.511

Billable

Basal cell carcinoma of skin of breast

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

Code Description

ICD-10 C44.511 is a billable code used to indicate a diagnosis of basal cell carcinoma of skin of breast.

Key Diagnostic Point:

Basal cell carcinoma (BCC) is the most common form of skin cancer, arising from the basal cells in the epidermis. When it occurs on the breast, it is often due to prolonged sun exposure, although it can also develop in areas not typically exposed to sunlight. BCC is characterized by slow growth and a low likelihood of metastasis, making it less aggressive than other skin cancers. Clinically, it may present as a pearly or waxy bump, a flat scar-like lesion, or a sore that does not heal. Surgical excision is the primary treatment, with the goal of achieving clear surgical margins to minimize recurrence. Reconstruction may be necessary depending on the size and location of the excised lesion. Proper coding for BCC of the breast requires careful documentation of the lesion's characteristics, treatment performed, and any reconstructive procedures undertaken. Understanding the nuances of skin cancer coding, particularly in relation to surgical margins and the implications of sun exposure, is crucial for accurate billing and compliance.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of skin cancers
  • Documenting surgical margins accurately
  • Understanding the implications of sun exposure
  • Reconstruction procedures post-excision

Audit Risk Factors

  • Inadequate documentation of surgical margins
  • Failure to specify the type of reconstruction performed
  • Misclassification of skin cancer type
  • Lack of clarity on the extent of sun exposure

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

Detailed descriptions of the lesion, treatment plans, and follow-up care.

Common Clinical Scenarios

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

Billing Considerations

Ensure clear documentation of margins and any reconstructive procedures performed.

Oncology

Documentation Requirements

Comprehensive treatment plans, including chemotherapy or radiation if applicable.

Common Clinical Scenarios

Management of advanced skin cancers and coordination of care with dermatology.

Billing Considerations

Document any systemic treatments and their indications.

Coding Guidelines

Inclusion Criteria

Use C44.511 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the diagnosis, treatment, and any complications
  • Include details about the surgical procedure and margins to support the coding

Exclusion Criteria

Do NOT use C44.511 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

11600CPT Code

Excision, malignant skin lesion

Clinical Scenario

Used when excising a BCC from the breast.

Documentation Requirements

Document size, location, and margins of the excised lesion.

Specialty Considerations

Dermatologists should ensure detailed operative notes.

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, 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, 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 treatment for basal cell carcinoma?

The primary treatment for basal cell carcinoma is surgical excision, which aims to remove the cancerous tissue while ensuring clear margins to prevent recurrence.