C43.4
BillableMalignant melanoma of scalp and neck
HCC Category Mapping
V28HCC 23 — Melanoma and Other Skin Cancers
0.251V24HCC 12 — Breast, Prostate, and Other Cancers and Tumors
0.150ESRDHCC 12 — Breast, Prostate, and Other Cancers and Tumors
0.000RxHCCHCC 22 — Cancer, Other Specified Sites
0.000What This Code Means
A type of skin cancer (melanoma) that starts on the scalp (top of the head) or neck.
Coding Tips
- •This code combines both scalp and neck locations; documentation should clarify which area is affected
- •Ensure the melanoma is not on the face or ears, which have separate codes
Clinical Significance
Malignant melanoma of the scalp and neck. The scalp is one of the most dangerous sites for melanoma, with scalp melanomas carrying significantly worse prognosis than melanomas at most other body sites — studies show up to twice the mortality rate. This is attributed to the rich vascular supply of the scalp and delayed detection under hair-covered skin.
Documentation Requirements
- ✓Specific location (scalp vertex, temporal scalp, occipital scalp, anterior neck, posterior neck, lateral neck)
- ✓Breslow depth — particularly critical given the aggressive behavior of scalp melanoma
- ✓Ulceration status and mitotic rate
- ✓Sentinel lymph node biopsy results (multiple drainage basins possible for scalp)
- ✓AJCC staging
- ✓Hair-bearing vs. non-hair-bearing scalp
Commonly Confused Codes
C43.39 — Melanoma of other parts of face; the junction between face and scalp (forehead/hairline) can be ambiguousC43.21/C43.22 — Melanoma of ear; postauricular melanoma may be classified as scalp/neck or earC43.30 — Melanoma of unspecified face; face vs. scalp distinction at the hairlineD03.4 — Melanoma in situ of scalp and neck; non-invasive, no HCC mapping
Code Hierarchy
└C43Malignant melanoma of skin└C43.4Malignant melanoma of scalp and neck
└C43.4Malignant melanoma of scalp and neck