Question 1

What is ICD-10 code C44.1191?

Accepted Answer

C44.1191 is the ICD-10-CM diagnosis code for basal cell carcinoma of skin of left upper eyelid, including canthus. A type of skin cancer (basal cell carcinoma) that develops on the left upper eyelid or the corner of the left eye. C44.1191 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering melanoma and other malignant neoplasms of skin (c43-c44).

C44.1191 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.

Ensure documentation clearly indicates left side and upper eyelid location.

Question 2

Is C44.1191 an HCC code?

Accepted Answer

No. C44.1191 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 C44.1191 billable?

Accepted Answer

Yes. C44.1191 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. C44.1191 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 C44.1191?

Accepted Answer

C44.1191 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 C44.1191 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 C44.1191?

Accepted Answer

Ensure documentation clearly indicates left side and upper eyelid location Do not use this code if the eyelid location is unspecified; use C44.111 instead

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C44.1191

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C44.1191 ICD-10-CM Code: Basal cell carcinoma of skin of left upper eyelid, including canthus

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C44.1191

Is C44.1191 an HCC code?

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