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C43 ICD-10-CM Code: Malignant melanoma of skin

C43 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC Buddy coding tools

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FY 2026 Apr update / Neoplasms (C00-D49) / Melanoma and other malignant neoplasms of skin (C43-C44)

C43

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Malignant melanoma of skin

Malignant melanoma of skin

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
C4Melanoma and other malignant neoplasms of skin (C43-C44)
C43Malignant melanoma of skin

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for C43 in this effective period.

Excludes 2

Official
  • malignant melanoma of skin of genital organs (C51-C52, C60.-, C63.-)
  • Merkel cell carcinoma (C4A.-)
  • sites other than skin-code to malignant neoplasm of the site

Related Child Codes

Official
C43.0Malignant melanoma of lip
C43.1Malignant melanoma of eyelid, including canthus
C43.2Malignant melanoma of ear and external auricular canal
C43.3Malignant melanoma of other and unspecified parts of face
C43.4Malignant melanoma of scalp and neck

Includes

Official

ICD-10-CM does not list Includes notes for C43 in this effective period.

Excludes 1

Official
  • melanoma in situ (D03.-)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for C43 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for C43 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for C43 in this effective period.

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Code
C43
Description
Malignant melanoma of skin
HCC (V28)
No CMS-HCC V28 mapping
RAF
Billable
No
Payment year
2026

Coder workflow notes

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What This Code Means

C43 is the ICD-10-CM diagnosis code for malignant melanoma of skin. C43 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering melanoma and other malignant neoplasms of skin (c43-c44).

Header codes like C43 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at C43's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for C43 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 1, Do NOT code together

  • melanoma in situ (D03.-)

Excludes 2, Not included here, may code separately

  • malignant melanoma of skin of genital organs (C51-C52, C60.-, C63.-)
  • Merkel cell carcinoma (C4A.-)
  • sites other than skin-code to malignant neoplasm of the site

Child Codes

Code Hierarchy

C43Malignant melanoma of skin
C43Malignant melanoma of skin

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