Merkel Cell Carcinoma B069

Current RMA Instruments:

Changes from previous Instruments:

ICD Coding:

• ICD-10-AM Codes: C00.0, C00.1, C00.2, C00.6, C00.8, C00.9, C44, C51.0, C51.1, C51.2, C51.8, C51.9, C60.0, C60.1, C60.2, C60.8, C60.9, C63.2, D04, D07.1, D07.4

Brief description:

Merkel cell carcinoma (MCC) is a rare and aggressive form of skin cancer that arises from Merkel cells. These cells are part of the neuroendocrine system and are found in the skin.  

Confirming the diagnosis:

To confirm the diagnosis, there needs to be a histopathology report confirming Merkel cell carcinoma.

To establish this diagnosis, the assessment and/or management may involve consultation with the following medical specialists: a dermatologist, a plastic surgeon and/or an oncologist. 

Additional diagnoses covered by SOP

• Nil

Conditions not covered by SOP

• Basal cell carcinoma (BCC) of the skin * Non melanoma malignant neoplasm of the skin 
• Bowen’s disease * Non melanoma malignant neoplasm of the skin 
• Carcinoma-in-situ of the skin * Non melanoma malignant neoplasm of the skin 
• Squamous cell carcinoma (SCC) of the skin *
• Kaposi’s sarcoma of the skin *
• Keratoacanthoma ^#
• Lymphoma of the skin * - Hodgkin's lymphoma or non-Hodgkin's lymphoma
• Malignant melanoma of the skin *
• Soft tissue sarcoma * of the skin
• Solar keratosis *

* another SOP applies  - the SOP has the same name unless otherwise specified

^# non-SOP condition

Clinical onset

Merkel cell carcinoma (MCC) usually presents as a painless, firm, and shiny dome- shaped nodule that can be red-violet in colour. These lesions are associated with rapid growth and although can be found anywhere, they typically are located on sun-exposed areas such as the head, neck or upper extremities. The clinical onset is the first clinical signs of this condition confirmed to be consistent with Merkel cell carcinoma by the treating doctor before it was subsequently confirmed by histology.  

Clinical worsening

For clinical worsening, the SOP only has an 'inability to obtain appropriate clinical management factor.'  Failure to undergo timely treatment could result in permanent worsening in the form or local invasion/destruction of normal tissue, metastasis or death from the disease.