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C43

Non-Billable (Header)

Malignant melanoma of skin

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

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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