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BETA v.3.0

2025 ICD-10-CM code C4A.0

Merkel cell carcinoma of the lip.

Do not use C4A.0 for malignant neoplasm of the vermilion border of the lip (C00.0-C00.2).

Medical necessity is established by the diagnosis of Merkel cell carcinoma, a rare and aggressive skin cancer requiring prompt treatment to prevent spread.

Diagnosis is based on history, physical examination, biopsy, sentinel node biopsy, and imaging (CT, MRI, PET). Treatment involves surgical resection if possible, along with chemotherapy and/or radiotherapy.

In simple words: A rare, aggressive skin cancer of the lip, often appearing as a firm, painless lump or bump that can be pink, red, or purple.

Malignant neuroendocrine neoplasm of the lip arising from Merkel cells, typically presenting as a fast-growing, painless mass. It can spread to the oral cavity or other sites via lymphatic channels.

Example 1: A 75-year-old patient presents with a rapidly growing, painless, purple nodule on the lower lip. Biopsy confirms Merkel cell carcinoma., A 60-year-old immunosuppressed patient develops a firm, pink bump on the upper lip.Following excision, pathology reveals Merkel cell carcinoma., An 80-year-old with a history of sun exposure presents with a red lesion on the lip.Biopsy and imaging confirm Merkel cell carcinoma with spread to regional lymph nodes.

Documentation should include the location and laterality of the lesion, biopsy results, imaging findings, and treatment plan.

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