# Size of a lesion



## DAPHNE JONES (Nov 14, 2011)

I have a excision of malignant lesion shoulder measuring 3x2.5cm how much cm is this total 7.5?? Or do you just use the 2.5 ?? Confused.....


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## mitchellde (Nov 14, 2011)

When coding a lesion excision you use the largest diameter documented plus the documeted margin but if the margins are not documented then you can only use the largest documented diameter.  In you case that would be 3cm, if the provider also documented that he had say 2cm margins then you add the margins for each side of the lesion so it would be 3 cm(the lesion diameter) + 2cm (the left side margin + 2cm The rt side margin = 7cm total excised diameter.


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## kumeena (Nov 14, 2011)

Hi Debra,

Why it is only 2sides (RT & LT) why can't we add top & bottom also?


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## Lorisvg (Nov 15, 2011)

You can only charge going in one direction.
Charging all 4 sides of margins, and the largest diameter would be fraudulent.

You only code the largest of the diameter measurement. In this case the 3cm. 
Adding margins to the top and bottom would then mean you are using the smaller diameter - in this scenario that's 2.5


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## mitchellde (Nov 15, 2011)

kumeena said:


> Hi Debra,
> 
> Why it is only 2sides (RT & LT) why can't we add top & bottom also?



Because you add to each side of fhe largest diameter.  Draw youself an oval to represent the elliptical excision.  Now make a line from end to end of the largest diameter of the lesion within that oval the space on either side between the lesion and the excision edge is the margin on both sidez of that line.


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## Tracey Thompson (Nov 15, 2011)

Also, some excision codes (such as 114XX or 116XX) actually state within the code description "excised diameter" not total surface area excised.  Diameter is the width, not the total surface area.

Example: Excision, malignant lesion including margins, trunk, arms, or legs; *excised diameter* over 4.0 cm 

Hope this helps!


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## CHRISTYMAC (Feb 10, 2016)

*Converting MM to CM*

have a path report with 5x4x4mm how would you convert mm to cm to get the correct CPT?


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## mitchellde (Feb 10, 2016)

Take the largest diameter and divide by 10.  There are 10 mm in a cm.


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## CHRISTYMAC (Feb 10, 2016)

*How do you convert mm to cm for a lesion*

I have a path report that has 4x5x4mm how would this be converted to cm? Does anyone know where I can find a chart converting mm to cm?

Thank you.


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## mhstrauss (Feb 10, 2016)

Debra's answer above is correct...10mm = 1cm. Divide the diameter of the widest part of the lesion by 10. In your example, it appears to be 5mm, (unless margins are included, in which case read through the previous replies to figure the diameter), which converts to 0.5cm.


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## CHRISTYMAC (Feb 10, 2016)

*MM to CM*

Thank you Debra and Michelle. Do either of you know where I can find a conversion chart? I would like to have for reference and also send it to our clinics. 

Thanks.


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## mitchellde (Feb 10, 2016)

Just look it up on the internet but it really is as simply as move the decimal over one place to the left.  The same as divide by ten. So 1 mm is .1 cm, 2 mm is .2 cm and so on.


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