The Centers for Medicare and Medicaid Services (CMS) released a new ICD-9-CM code set that deals specifically with malignant neoplasms for medical billing. These updated dermatology codes become effective October 1, 2011.

Out of about 250 changes to the ICD-9-CM codes, there are 40 new codes for malignant neoplasms with new descriptors.  These include type specifications such as:

Fifth Digit is “0” for “unspecified;”

fifth digit is 1 for “basal cell carcinoma;”

fifth digit is “2” for “squamous cell carcinoma;”

and fifth digit is “9” for “other specified.”

About 10 codes were also deleted to accommodate the new codes, which are more specific in their descriptors.

Basal cell carcinomas and squamous cell carcinomas don't get reported to cancer registries, even though they are the most common forms of skin cancer. The addition of these codes will enable easy identification of these carcinomas without an in depth review of medical records. Under the new code set, skin cancers are reported with site specified. For skin neoplasms of unspecified site, 173.9x is the reserved category.

The new codes are:

173.0   Other malignant neoplasm of skin of lip

            173.00 Unspecified malignant neoplasm of skin of lip

            173.01 Basal cell carcinoma of skin of lip

            173.02 Squamous cell carcinoma of skin of lip

            173.09 Other specified malignant neoplasm of skin of lip

173.1   Other malignant neoplasm of skin of eyelid, including canthus

            173.10 Unspecified malignant neoplasm of eyelid, including canthus

            173.11 Basal cell carcinoma of eyelid, including canthus

            173.12 Squamous cell carcinoma of eyelid, including canthus

            173.19 Other specified malignant neoplasm of eyelid, including canthus

173.2   Other malignant neoplasm of skin of ear and external auditory canal

            173.20 Unspecified malignant neoplasm of skin of ear and external auditory canal

            173.21 Basal cell carcinoma of skin of ear and external auditory canal

            173.22 Squamous cell carcinoma of skin of ear and external auditory canal

            173.29 Other specified malignant neoplasm of skin of ear and external auditory canal

173.3   Other malignant neoplasm of skin of other and unspecified parts of face

            173.30 Unspecified malignant neoplasm of skin of other and unspecified parts of face

            173.31 Basal cell carcinoma of skin of other and unspecified parts of face

            173.32 Squamous cell carcinoma of skin of other and unspecified parts of face

            173.39 Other specified malignant neoplasm of skin of other and unspecified parts of face

173.4   Other malignant neoplasm of scalp and skin of neck

            173.40 Unspecified malignant neoplasm of scalp and skin of neck

            173.41 Basal cell carcinoma of scalp and skin of neck

            173.42 Squamous cell carcinoma of scalp and skin of neck

173.49 Other specified malignant neoplasm of scalp and skin of neck

173.5   Other malignant neoplasm of skin of trunk, except scrotum

            173.50 Unspecified malignant neoplasm of skin of trunk, except scrotum

            173.51 Basal cell carcinoma of skin of trunk, except scrotum

            173.52 Squamous cell carcinoma of skin of trunk, except scrotum

            173.59 Other specified malignant neoplasm of skin of trunk, except scrotum

173.6   Other malignant neoplasm of skin of upper limb, including shoulder

            173.60 Unspecified malignant neoplasm of skin of upper limb, including shoulder

            173.61 Basal cell carcinoma of skin of upper limb, including shoulder

            173.62 Squamous cell carcinoma of skin of upper limb, including shoulder

            173.69 Other specified malignant neoplasm of skin of upper limb, including shoulder

173.7   Other malignant neoplasm of skin of lower limb, including hip

            173.70 Unspecified malignant neoplasm of skin of lower limb, including hip

            173.71 Basal cell carcinoma of skin of lower limb, including hip

            173.72 Squamous cell carcinoma of skin of lower limb, including hip

            173.79 Other specified malignant neoplasm of skin of lower limb, including hip

173.8   Other malignant neoplasm of other specified sites of skin

            173.80 Unspecified malignant neoplasm of other specified sites of skin

            173.81 Basal cell carcinoma of other specified sites of skin

            173.82 Squamous cell carcinoma of other specified sites of skin

            173.89 Other specified malignant neoplasm of other specified sites of skin

173.9   Other malignant neoplasm of skin, site unspecified

            173.90 Unspecified malignant neoplasm of skin, site unspecified

            173.91 Basal cell carcinoma of skin, site unspecified

            173.92 Squamous cell carcinoma of skin, site unspecified

            173.99 Other specified malignant neoplasm of skin, site unspecified