Non Melanoma Malignant Neoplasm of the Skin B046

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:

Non melanoma malignant neoplasms are cancers that arise from skin cells other than melanocytes. The two main types are basal and squamous cell carcinoma of the skin. Basal cell carcinomas are the most common and make up approximately 70% of non-melanoma skin cancers. 

Confirming the diagnosis:

To confirm the diagnosis, there needs to be a histopathology report confirming a non-melanoma malignant neoplasm (with the specific diagnosis). 

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. 

Diagnoses covered by SOP

• Basal cell carcinoma (BCC) of the skin 
• Bowen’s disease
• Carcinoma-in-situ of the skin
• Squamous cell carcinoma (SCC) of the skin
• BCC or SCC of anogenital skin (including skin of penis)
• Non-melanoma malignant neoplasm of the external aspect of the lip (lipstick area), subungual skin (area beneath the nail plate of a finger or toe), external auditory canal skin (in the ear), and anogenital skin 

Conditions not covered by SOP

• Carcinoid tumour #
• Hodgkin lymphoma *
• Kaposi’s sarcoma of the skin *
• Keratoacanthoma #
• Lymphoma of the skin* - Hodgkin's lymphoma or non-Hodgkin's lymphoma
• Malignant melanoma of the skin*
• Mammary and extramammary Paget disease * Malignant neoplasm of the breast or non-SoP
• Merkel cell carcinoma *
• Non-melanoma malignant neoplasm mucosa lining the oral (inner aspects of the lips, conjunctiva and anogenital mucosa) #
• Non-Hodgkin lymphoma *
• 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

The clinical onset is defined as the first appearance of clinical signs consistent with a non-melanoma malignant neoplasm, as documented by the treating doctor, and subsequently confirmed by histopathology examination. 

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.