# Pathology Billing



## jdavenport02 (Jun 25, 2010)

A patient has skin cancer on the arm (ICD9 173.6)...it is removed once and found benign (ICD9 216.6)...then another portion is removed again and found malignant (ICD9 173.6).  Can the ICD9 code for all three charges be 173.6 considering that probably it was just a small portion that was found benign?

The patient has Department of Labor for insurance because he obtained the skin cancer while working for a government agency and they will only pay for ICD9 code 173.6.

HELP PLEASE!!!


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## mitchellde (Jun 25, 2010)

was this three different lesions or all parts of the same excision?  Also how did it start out malignant and then after excision become benign?  At least that is how it reads to me.


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## jdavenport02 (Jun 25, 2010)

*Report Notes*

The comment on the report where the benign excision states this:

The prev biopsy from the right radial wrist  is reviewed and shows a superficial invasive squamous cell carcinoma transected along the shave biopsy margin.  Therefore the absence of residual tumor in the current specimen is most likely due to the inflammatory and reparative response to the prev biopsy.


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## mitchellde (Jun 25, 2010)

Ah that is not a benign dx, it is just an explanation for why there is no dx of extension, in otherowrds the excision did not go far enough beyond the scar of the previous biopsy.  I am guesing then that is why there is then another excision as they want to get an answer as to the extent of the invasion.  so it is all 173.6


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