Notification



Notification Issue Date:



Policy Attachment


Attachment to Policy # 11.07.02j


Attachment:A

Policy #:11.07.02j

Description:ICD-10 Codes

Title:Sentinel Lymph Node Biopsy and Mapping


Inclusion of a code in this table does not imply reimbursement. Eligibility, benefits, limitations, exclusions, precertification/referral requirements, provider contracts, and Company policies apply.

The codes listed below are updated on a regular basis, in accordance with nationally accepted coding guidelines. Therefore, this policy applies to any and all future applicable coding changes, revisions, or updates.

In order to ensure optimal reimbursement, all health care services, devices, and pharmaceuticals should be reported using the billing codes and modifiers that most accurately represent the services rendered, unless otherwise directed by the Company.



C43.0 Malignant melanoma of lip

C43.111 Malignant melanoma of right upper eyelid, including canthus

C43.112 Malignant melanoma of right lower eyelid, including canthus

C43.121 Malignant melanoma of left upper eyelid, including canthus

C43.122 Malignant melanoma of left lower eyelid, including canthus

C43.21 Malignant melanoma of right ear and external auricular canal

C43.22 Malignant melanoma of left ear and external auricular canal

C43.31 Malignant melanoma of nose

C43.39 Malignant melanoma of other parts of face

C43.4 Malignant melanoma of scalp and neck

C43.51 Malignant melanoma of anal skin

C43.52 Malignant melanoma of skin of breast

C43.59 Malignant melanoma of other part of trunk

C43.61 Malignant melanoma of right upper limb, including shoulder

C43.62 Malignant melanoma of left upper limb, including shoulder

C43.71 Malignant melanoma of right lower limb, including hip

C43.72 Malignant melanoma of left lower limb, including hip

C43.8 Malignant melanoma of overlapping sites of skin

C43.9 Malignant melanoma of skin, unspecified

C44.02 Squamous cell carcinoma of skin of lip

C44.1221 Squamous cell carcinoma of skin of right upper eyelid, including canthus

C44.1222 Squamous cell carcinoma of skin of right lower eyelid, including canthus

C44.1291 Squamous cell carcinoma of skin of left upper eyelid, including canthus

C44.1292 Squamous cell carcinoma of skin of left lower eyelid, including canthus

C44.222 Squamous cell carcinoma of skin of right ear and external auricular canal

C44.229 Squamous cell carcinoma of skin of left ear and external auricular canal

C44.321 Squamous cell carcinoma of skin of nose

C44.329 Squamous cell carcinoma of skin of other parts of face

C44.42 Squamous cell carcinoma of skin of scalp and neck

C44.520 Squamous cell carcinoma of anal skin

C44.521 Squamous cell carcinoma of skin of breast

C44.529 Squamous cell carcinoma of skin of other part of trunk

C44.622 Squamous cell carcinoma of skin of right upper limb, including shoulder

C44.629 Squamous cell carcinoma of skin of left upper limb, including shoulder

C44.722 Squamous cell carcinoma of skin of right lower limb, including hip

C44.729 Squamous cell carcinoma of skin of left lower limb, including hip

C44.82 Squamous cell carcinoma of overlapping sites of skin

C44.92 Squamous cell carcinoma of skin, unspecified

C4A.0 Merkel cell carcinoma of lip

C4A.111 Merkel cell carcinoma of right upper eyelid, including canthus

C4A.112 Merkel cell carcinoma of right lower eyelid, including canthus

C4A.121 Merkel cell carcinoma of left upper eyelid, including canthus

C4A.122 Merkel cell carcinoma of left lower eyelid, including canthus

C4A.21 Merkel cell carcinoma of right ear and external auricular canal

C4A.22 Merkel cell carcinoma of left ear and external auricular canal

C4A.31 Merkel cell carcinoma of nose

C4A.39 Merkel cell carcinoma of other parts of face

C4A.4 Merkel cell carcinoma of scalp and neck

C4A.51 Merkel cell carcinoma of anal skin

C4A.52 Merkel cell carcinoma of skin of breast

C4A.59 Merkel cell carcinoma of other part of trunk

C4A.61 Merkel cell carcinoma of right upper limb, including shoulder

C4A.62 Merkel cell carcinoma of left upper limb, including shoulder

C4A.71 Merkel cell carcinoma of right lower limb, including hip

C4A.72 Merkel cell carcinoma of left lower limb, including hip

C4A.8 Merkel cell carcinoma of overlapping sites

C4A.9 Merkel cell carcinoma, unspecified

C50.011 Malignant neoplasm of nipple and areola, right female breast

C50.012 Malignant neoplasm of nipple and areola, left female breast

C50.021 Malignant neoplasm of nipple and areola, right male breast

C50.022 Malignant neoplasm of nipple and areola, left male breast

C50.111 Malignant neoplasm of central portion of right female breast

C50.112 Malignant neoplasm of central portion of left female breast

C50.121 Malignant neoplasm of central portion of right male breast

C50.122 Malignant neoplasm of central portion of left male breast

C50.211 Malignant neoplasm of upper-inner quadrant of right female breast

C50.212 Malignant neoplasm of upper-inner quadrant of left female breast

C50.221 Malignant neoplasm of upper-inner quadrant of right male breast

C50.222 Malignant neoplasm of upper-inner quadrant of left male breast

C50.311 Malignant neoplasm of lower-inner quadrant of right female breast

C50.312 Malignant neoplasm of lower-inner quadrant of left female breast

C50.321 Malignant neoplasm of lower-inner quadrant of right male breast

C50.322 Malignant neoplasm of lower-inner quadrant of left male breast

C50.411 Malignant neoplasm of upper-outer quadrant of right female breast

C50.412 Malignant neoplasm of upper-outer quadrant of left female breast

C50.421 Malignant neoplasm of upper-outer quadrant of right male breast

C50.422 Malignant neoplasm of upper-outer quadrant of left male breast

C50.511 Malignant neoplasm of lower-outer quadrant of right female breast

C50.512 Malignant neoplasm of lower-outer quadrant of left female breast

C50.521 Malignant neoplasm of lower-outer quadrant of right male breast

C50.522 Malignant neoplasm of lower-outer quadrant of left male breast

C50.611 Malignant neoplasm of axillary tail of right female breast

C50.612 Malignant neoplasm of axillary tail of left female breast

C50.621 Malignant neoplasm of axillary tail of right male breast

C50.622 Malignant neoplasm of axillary tail of left male breast

C50.811 Malignant neoplasm of overlapping sites of right female breast

C50.812 Malignant neoplasm of overlapping sites of left female breast

C50.821 Malignant neoplasm of overlapping sites of right male breast

C50.822 Malignant neoplasm of overlapping sites of left male breast

C50.911 Malignant neoplasm of unspecified site of right female breast

C50.912 Malignant neoplasm of unspecified site of left female breast

C51.0 Malignant neoplasm of labium majus

C51.1 Malignant neoplasm of labium minus

C51.2 Malignant neoplasm of clitoris

C51.9 Malignant neoplasm of vulva, unspecified

C54.1 Malignant neoplasm of endometrium

C60.0 Malignant neoplasm of prepuce

C60.1 Malignant neoplasm of glans penis

C60.2 Malignant neoplasm of body of penis

C60.8 Malignant neoplasm of overlapping sites of penis

C60.9 Malignant neoplasm of penis, unspecified

D03.0 Melanoma in situ of lip

D03.111 Melanoma in situ of right upper eyelid, including canthus

D03.112 Melanoma in situ of right lower eyelid, including canthus

D03.121 Melanoma in situ of left upper eyelid, including canthus

D03.122 Melanoma in situ of left lower eyelid, including canthus

D03.21 Melanoma in situ of right ear and external auricular canal

D03.22 Melanoma in situ of left ear and external auricular canal

D03.39 Melanoma in situ of other parts of face

D03.4 Melanoma in situ of scalp and neck

D03.51 Melanoma in situ of anal skin

D03.52 Melanoma in situ of breast (skin) (soft tissue)

D03.59 Melanoma in situ of other part of trunk

D03.61 Melanoma in situ of right upper limb, including shoulder

D03.62 Melanoma in situ of left upper limb, including shoulder

D03.71 Melanoma in situ of right lower limb, including hip

D03.72 Melanoma in situ of left lower limb, including hip

D03.9 Melanoma in situ, unspecified

D05.01 Lobular carcinoma in situ of right breast

D05.02 Lobular carcinoma in situ of left breast

D05.11 Intraductal carcinoma in situ of right breast

D05.12 Intraductal carcinoma in situ of left breast

D05.81 Other specified type of carcinoma in situ of right breast

D05.82 Other specified type of carcinoma in situ of left breast

D05.91 Unspecified type of carcinoma in situ of right breast

D05.92 Unspecified type of carcinoma in situ of left breast

D07.0 Carcinoma in situ of endometrium

D07.4 Carcinoma in situ of penis

D29.0 Benign neoplasm of penis


Version Effective Date: 05/31/2019
Version Issued Date: 05/31/2019
Version Reissued Date: N/A

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