# Excision of margins only



## Shawna Paul (Sep 18, 2012)

My question is - can you bill for a reexcision of margins only?  

I have a patient who had a lesion removed and the pathologist recommend additional margins be submitted for pathology.  Can you code just the reexcision of the margins only?  Any help would be greatly appreciated.  

Thanks,
Shawna


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## syllingk (Sep 20, 2012)

Was it done in the same operative session?


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## rthames052006 (Sep 21, 2012)

Shawna Paul said:


> My question is - can you bill for a reexcision of margins only?
> 
> I have a patient who had a lesion removed and the pathologist recommend additional margins be submitted for pathology.  Can you code just the reexcision of the margins only?  Any help would be greatly appreciated.
> 
> ...



When a malignant lesion is excised and the patient returns for a re-excision for postiive margins, the re-excision is reported as a malignant lesion, even though the pathology  report may indicate that the re-excision reveals "no residual tumor"

As stated in the guidelines, when an additional excision is necessary for complete tumor removal and is performed during the same surgical session, only one codes is used to report the additional excision and re-excision(s) based on the widest excised diameter required for complete tumor removal at the same operative session.  Modifier 58 should be appended if the re-excision procedure is performed during the postoperative period of the primary excision procedure.  Modifier 59 should be appended if the procedure is performed at a separate session on the same day of surgery.

Example:  a patient had  1.5 cm malignant lesion excised from his leg at a previous operative session. Subsequently, during the post op period, residual tumor was noted at the margin of the original excision and the margins were re-excised.  The re-excision included a 1.0 cm excised diameter.  In this example, code 11601 - 58 should be reported.

I hope the above info helps.

Good luck


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