Question 1

What is ICD-10 code C44.1322?

Accepted Answer

C44.1322 is the ICD-10-CM diagnosis code for sebaceous cell carcinoma of skin of right lower eyelid, including canthus. A rare type of skin cancer (sebaceous cell carcinoma) that develops on the lower eyelid of the right eye, including the corner where the eyelids meet. C44.1322 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering melanoma and other malignant neoplasms of skin (c43-c44).

C44.1322 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.

Confirm the specific eyelid location (lower) and laterality (right) are documented in the medical record.

Question 2

Is C44.1322 an HCC code?

Accepted Answer

No. C44.1322 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 C44.1322 billable?

Accepted Answer

Yes. C44.1322 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. C44.1322 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 C44.1322?

Accepted Answer

C44.1322 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 C44.1322 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 C44.1322?

Accepted Answer

Confirm the specific eyelid location (lower) and laterality (right) are documented in the medical record This is a high-grade malignancy with potential for orbital involvement - review for any extension beyond the eyelid

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C44.1322

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C44.1322 ICD-10-CM Code: Sebaceous cell carcinoma of skin of right lower eyelid, including canthus

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C44.1322

Is C44.1322 an HCC code?

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Child Codes

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