Question 1

What is ICD-10 code C44.111?

Accepted Answer

C44.111 is the ICD-10-CM diagnosis code for basal cell carcinoma of skin of unspecified eyelid, including canthus. A type of skin cancer (basal cell carcinoma) that develops on the eyelid or the corner of the eye, but the specific eyelid location is not specified. C44.111 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering melanoma and other malignant neoplasms of skin (c43-c44).

C44.111 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.

Use this code only when the specific eyelid (upper/lower) and side (right/left) cannot be determined from documentation.

Question 2

Is C44.111 an HCC code?

Accepted Answer

No. C44.111 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 C44.111 billable?

Accepted Answer

Yes. C44.111 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. C44.111 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 C44.111?

Accepted Answer

C44.111 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 model rewards C44.111 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a payment HCC.

Question 5

What should coders know when reporting C44.111?

Accepted Answer

Use this code only when the specific eyelid (upper/lower) and side (right/left) cannot be determined from documentation If laterality and eyelid position are documented, use the more specific codes (C44.1121, C44.1122, C44.1191, or C44.1192)

HCC Buddy Code Card

C44.111

Is C44.111 an HCC code?

Get the V28 RAF + MEAT cheat sheet

What This Code Means

Coding Tips

Child Codes

Code Hierarchy

Work C44.111 in HCC Buddy

C44.111 ICD-10-CM Code: Basal cell carcinoma of skin of unspecified eyelid, including canthus

HCC Buddy Code Card

C44.111

Is C44.111 an HCC code?

Get the V28 RAF + MEAT cheat sheet

What This Code Means

Coding Tips

Child Codes

Code Hierarchy

Work C44.111 in HCC Buddy