ICD-9: Carcinoma vs. Melanoma

A carcinoma (e.g, basal cell carcinoma or squamous cell carcinoma) is a malignant growth consisting of epithelial cells, which tend to spread to surrounding tissue. Carcinomas are often associated with the skin, but can also develop in tissues lining organs, such as the kidney or liver. Carcinomas are identified in the ICD-9-CM Index to Diseases under Carcinoma. Accompanying this term is the directive, “-see also Neoplasm, by site, malignant” Basal cell or squamous cell carcinomas are listed in ICD-9-CM code category 173.x Other malignant neoplasm of skin.
A melanoma is a tumor arising from the melanocystic system of the skin. Used alone, the term “melanoma” refers to a malignant melanoma. Melanomas are identified by ICD-9-CM code category 172.x Malignant melanoma of skin.
In both categories 172.x and 173.x, the fourth digit identifies location of skin carcinoma or melanoma based on the body area.

• 0 – lips
• 1 – eyelids, including canthus
• 2 – ears and external auditory canal
• 3 – other and unspecified parts of face, to include the (external) cheek, chin, eyebrow, forehead, (external) nose, and temples.
• 4 – neck and scalp.
• 5 – trunk (excluding the scrotum, for men); this includes neoplasm on the breast, or a suspicious lesion on the skin surface of the breast, for both men and women, and also includes the buttocks.
• 6 – arms, including shoulders and hands/fingers
• 7 – legs, including hip and feet/toes
• 8 – other specified sites (e.g., the provider specifies a site that not included in any of the listed categories)
• 9 – site unspecified: Use only when the provider does not specify the site of the lesion

Coding to a specific site, when available, is important, and also will play a role in supporting site-specific CPT® procedural codes.

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John Verhovshek

John Verhovshek, MA, CPC, is a contributing editor at AAPC. He has been covering medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University.

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