Squamous cell carcinoma (SCC) is a malignant neoplasm that originates from squamous epithelial cells. This common type of skin cancer can metastasize to other parts of the body, such as the lungs, esophagus, and genitalia. Early detection and prompt treatment can prevent the cancer from spreading or recurring. Coding malignant cancers is complex, as it requires precise identification of the cancer type, its anatomical location, and stage of development. By thoroughly reviewing clinical documentation, a medical coding company can help providers select the most accurate ICD-10 codes, ensuring optimal billing and compliance.
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Causes and Symptoms
SCC develops in many parts of the body, including the skin, mouth, throat, lungs, and lymph nodes. In the skin, the cancer often appears on sun-exposed areas such as face, ears, neck, lips, arms, and backs of the hands.
SCC is most commonly found in fair-skinned individuals with light hair, and light eyes. Several risk factors can contribute to its development, including:
- History of severe sunburns, especially in childhood
- History of skin cancer
- Excess UV radiation exposure, whether it’s from the sun or tanning beds.
- weakened immune system
- Having HPV
- Older age
- Contact with harmful chemicals
- Long-lasting scars or wounds on the skin
- Smoking
Signs and Symptoms
SCC may present in various ways, including:
- A growing bump with a rough, scaly surface or flat reddish patches
- A lump on the skin or beneath the nail
- A dome-shaped or crusty lesion that may bleed
- A sore that does not heal
Any changes in an existing wart, mole, or skin lesion should be monitored, as they could be early signs of SCC.
Diagnosis and Treatment
SCC is diagnosed through a clinical evaluation, often confirmed with a skin biopsy. Additional imaging tests may be required for more advanced cases to determine the extent of the disease.
The choice of treatment depends on the tumor’s location, stage, and overall progression. Small or localized SCC lesions are typically removed through surgical excision. Mohs surgery, a precise technique often used for skin SCC, involves removing cancerous tissue layer by layer while preserving as much healthy skin as possible. Radiation therapy is used for cases where surgery is not an option or when SCC has spread beyond the skin. Chemotherapy is typically reserved for advanced or metastatic SCC.
According to an article from MD Anderson Cancer Center, the latest advancement in SCC treatment involves administering immunotherapy before surgery. This approach stimulates the immune system to attack cancer cells, potentially improving surgical outcomes.
ICD-10 Codes for Squamous Cell Carcinoma
The ICD-10 codes for SCC depend on the location of the cancer and are as follows:
- C44.02:Squamous cell carcinoma of skin of lip
- C44.12: Squamous cell carcinoma of skin of eyelid, including canthus
- C44.121: Squamous cell carcinoma of skin of unspecified eyelid, including canthus
- C44.122: Squamous cell carcinoma of skin of right eyelid, including canthus
- C44.129: Squamous cell carcinoma of skin of left eyelid, including canthus
- C44.22: Squamous cell carcinoma of skin of ear and external auricular canal
- C44.221: Squamous cell carcinoma of skin of unspecified ear and external auricular canal
- C44.222: Squamous cell carcinoma of skin of right ear and external auricular canal
- C44.229: Squamous cell carcinoma of skin of left ear and external auricular canal
- C44.32: Squamous cell carcinoma of skin of other and unspecified parts of face
- C44.320: Squamous cell carcinoma of skin of unspecified parts of face
- C44.321: Squamous cell carcinoma of skin of nose
- C44.329: Squamous cell carcinoma of skin of other parts of face
- C44.42:Squamous cell carcinoma of skin of scalp and neck
- C44.52: Squamous cell carcinoma of skin of trunk
- C44.520: Squamous cell carcinoma of anal skin
- C44.521: Squamous cell carcinoma of skin of breast
- C44.529: Squamous cell carcinoma of skin of other part of trunk
- C44.62: Squamous cell carcinoma of skin of upper limb, including shoulder
- C44.621: Squamous cell carcinoma of skin of unspecified upper limb, including shoulder
- C44.622: Squamous cell carcinoma of skin of right upper limb, including shoulder
- C44.629: Squamous cell carcinoma of skin of left upper limb, including shoulder
- C44.72: Squamous cell carcinoma of skin of lower limb, including hip
- C44.721: Squamous cell carcinoma of skin of unspecified lower limb, including hip
- C44.722: Squamous cell carcinoma of skin of right lower limb, including hip
- C44.729: Squamous cell carcinoma of skin of left lower limb, including hip
- C44.82: Squamous cell carcinoma of overlapping sites of skin
- C44.92: Squamous cell carcinoma of skin, unspecified
Accurate ICD-10 coding for squamous cell carcinoma depends on detailed documentation. The clinical documentation should include the following:
- Specify whether the site is primary, secondary or carcinoma in situ. However, when the term SCC or squamous cell carcinoma is used without further definition, it is understood to be a primary site
- Exact site of the skin where SCC occurred
- Laterality
- Personal or family history of skin cancer, if any or current or history of smoking/smoking exposure
Patients should be educated about the importance of early detection and prompt treatment to prevent the cancer from spreading or recurring.
Ensure Accurate Coding
Accurate ICD-10 coding for squamous cell carcinoma (SCC) is essential for proper documentation, reimbursement, and compliance with medical billing regulations. Given the complexity of coding guidelines and the potential for claim denials, you can benefit significantly from medical billing and coding outsourcing. Outsourcing ensures precise coding, reduces administrative burdens, and enhances revenue cycle efficiency.
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