Question 1

What is ICD-10 code C44.01?

Accepted Answer

C44.01 is the ICD-10-CM diagnosis code for basal cell carcinoma of skin of lip. A basal cell carcinoma, the most common type of skin cancer, occurring on the lip. C44.01 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering melanoma and other malignant neoplasms of skin (c43-c44).

C44.01 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

Basal cell carcinoma is the most frequently occurring skin malignancy; ensure pathology report confirms this histology.

Question 2

Is C44.01 an HCC code?

Accepted Answer

No. C44.01 is a billable ICD-10-CM code but does not map to any payment HCC category under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can still be reported on Medicare Advantage encounter data submissions, but it does not contribute to the beneficiary's Risk Adjustment Factor (RAF) score and therefore does not affect the risk-adjusted capitation payment to the plan. V28 reached 100% phase-in for payment year 2026.

Question 3

Is C44.01 billable?

Accepted Answer

Yes. C44.01 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. C44.01 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Question 4

What is the V28 vs V24 difference for C44.01?

Accepted Answer

C44.01 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither community model rewards C44.01 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's V28/V24 community RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a community payment HCC.

Question 5

What should coders know when reporting C44.01?

Accepted Answer

Basal cell carcinoma is the most frequently occurring skin malignancy; ensure pathology report confirms this histology Document the specific location (upper or lower lip) and whether it involves the vermillion border for complete coding

HCC Buddy Code Card

C44.01

Is C44.01 an HCC code?

Get the V28 RAF + MEAT cheat sheet

What This Code Means

Coding Tips

Child Codes

Code Hierarchy

Work C44.01 in HCC Buddy

C44.01 ICD-10-CM Code: Basal cell carcinoma of skin of lip

HCC Buddy Code Card

C44.01

Is C44.01 an HCC code?

Get the V28 RAF + MEAT cheat sheet

What This Code Means

Coding Tips

Child Codes

Code Hierarchy

Work C44.01 in HCC Buddy