KEYTRUDA FOR RECURRENT OR METASTATIC CUTANEOUS SQUAMOUS CELL CARCINOMA (cSCC)
Download possible relevant diagnosis codes for cSCC

The following codes as of August 2020 are provided as a reference and may be relevant when billing for KEYTRUDA and its administration. Consult the relevant manual and/or other guidelines for a description of each code to determine the appropriateness of its use and for information on additional codes. Diagnosis codes should be selected only by a health care professional. You are solely responsible for determining the appropriate codes and for any action you take in billing.

When submitting a claim for KEYTRUDA, always verify coding requirements with the relevant payer. Coding requirements may vary by insurer or plan; please refer to the payer-specific policies to understand what may be covered.

Check with the relevant payer regarding guidance on which diagnoses they will recognize and the applicability of secondary codes. Health care professionals are solely responsible for selecting codes that appropriately reflect the patient’s diagnosis, the services rendered, and the applicable payers’ guidelines.

Providers should document the diagnosis with a sufficiently high degree of specificity based on the information available to enable the identification of the most appropriate code. Although CMS has said that an unspecified code may be appropriate in some cases, CMS has advised that you should always code with as much specificity as possible consistent with the clinical documentation.

Merck and its agents make no warranties concerning the accuracy or appropriateness of this information for your particular use given the frequent changes in public and private payer billing. Merck cautions that payer-coding requirements vary and can frequently change, so it is important to regularly check with each payer or, where applicable, the Medicare Administrative Contractor as to payer-specific requirements. The use of this information does not guarantee payment or that any payment received will cover your costs.

Indication

KEYTRUDA is indicated for the treatment of patients with recurrent or metastatic cutaneous squamous cell carcinoma (cSCC) that is not curable by surgery or radiation.

FDA-Approved Dosing

The FDA-approved dose of KEYTRUDA is either 200 mg administered as an intravenous infusion over 30 minutes every 3 weeks or 400 mg administered as an intravenous infusion over 30 minutes every 6 weeks, until disease progression, unacceptable toxicity, or up to 24 months.

KEYTRUDA is indicated for use at an additional recommended dosage of 400 mg every 6 weeks for all approved adult indications. This indication is approved under accelerated approval based on pharmacokinetic data, the relationship of exposure to efficacy, and the relationship of exposure to safety. Continued approval for this dosing may be contingent upon verification and description of clinical benefit in the confirmatory trials.

Possible relevant diagnosis codes for cSCC

Learn more about each diagnosis code and descriptor by selecting from the series options below.

 

C44: Other and Unspecified Malignant Neoplasm of Skin4
The C44 series:

  • Excludes: Kaposi's sarcoma of skin, malignant melanoma of skin, malignant neoplasm of skin of genital organs, Merkel cell carcinoma
ICD-10-CM CODE DESCRIPTOR
C44.0 Other and unspecified malignant neoplasm of skin of lip

C44.12: Squamous Cell Carcinoma of Skin of Eyelid, Including Canthus4

ICD-10-CM CODE DESCRIPTOR
C44.121 Squamous cell carcinoma of skin of unspecified eyelid, including canthus
C44.1221 Squamous cell carcinoma of skin of right upper eyelid, including canthus
C44.1222 Squamous cell carcinoma of skin of right lower eyelid, including canthus

C44.129: Squamous Cell Carcinoma of Skin of Left Eyelid, Including Canthus4

ICD-10-CM CODE DESCRIPTOR
C44.1291 Squamous cell carcinoma of skin of left upper eyelid, including canthus
C44.1292 Squamous cell carcinoma of skin of left lower eyelid, including canthus

C44.22: Squamous Cell Carcinoma of Skin of Ear and External Auricular Canal4

ICD-10-CM CODE DESCRIPTOR
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 Face4

ICD-10-CM CODE DESCRIPTOR
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

C44.4: Other and Unspecified Malignant Neoplasm of Skin of Scalp and Neck4

ICD-10-CM CODE DESCRIPTOR
C44.42 Squamous cell carcinoma of skin of scalp and neck

C44.52: Squamous Cell Carcinoma of Skin of Trunk4

ICD-10-CM CODE DESCRIPTOR
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 Shoulder4

ICD-10-CM CODE DESCRIPTOR
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 Hip4

ICD-10-CM CODE DESCRIPTOR
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

C44.8: Other and Unspecified Malignant Neoplasm of Overlapping Sites of Skin4

ICD-10-CM CODE DESCRIPTOR
C44.82 Squamous cell carcinoma of overlapping sites of skin

C44.9: Other and Unspecified Malignant Neoplasm of Skin, Unspecified4

ICD-10-CM CODE DESCRIPTOR
C44.92 Squamous cell carcinoma of skin, unspecified