2026 ICD-10-CM Diagnosis Code C43.0Malignant melanoma of lip
ICD-10-CM Codes›C00–D49›C43-C44›C43
- Billable — Valid for Submission
- Chronic Condition
C43.0 is a billable ICD-10-CM diagnosis code for malignant melanoma of lip. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 595 through 596. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Skin cancers - melanoma.
Code Identity
Code Classification
Quality Payment Program MeasuresBilling
Medicare quality measures that can apply when C43.0 is part of the patient record.
Melanoma Reporting
High Priority: YES
Measure Type: Process
Submission Methods: Claims, Registry
Description: Pathology reports for primary malignant cutaneous melanoma that include the pT category, thickness, ulceration and mitotic rate, peripheral and deep margin status and presence or absence of microsatellitosis for invasive tumors.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Malignant melanoma of lip
- Malignant melanoma of skin of lip
- Malignant melanoma of skin of lower lip
- Malignant melanoma of skin of upper lip
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Type 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
- Melanoma (malignant) - C43.9
- lip (lower) (upper) - C43.0
External Cause of Injuries IndexGuidance
References for this code in the External Cause of Injuries Index.
- Melanoma(malignant)
- skin
- lip (lower) (upper)
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Melanoma
Melanoma is the most serious type of skin cancer. Often the first sign of melanoma is a change in the size, shape, color, or feel of a mole. Most melanomas have a black or black-blue area. Melanoma may also appear as a new mole. It may be black, abnormal, or "ugly looking."
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert C43.0 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About C43.0Overview
Is C43.0 (Malignant melanoma of skin) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report malignant melanoma of lip on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does C43.0 group to?
When malignant melanoma of lip is the principal diagnosis on an inpatient stay, it groups to MS-DRG 595, 596, with relative weights from 1.0825 to 2.1207 depending on complications. Higher weights mean higher Medicare reimbursement.
What is the ICD-9 equivalent of C43.0?
Under the General Equivalence Mappings, malignant melanoma of lip converts to ICD-9-CM 172.0 (malig melanoma lip). The mapping is approximate, so confirm the match fits the documentation.
Footnotes
[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:
- The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
- The condition places limitations on self-care, independent living, and social interactions.
