# skin lesion measurement



## elenax (Mar 26, 2008)

Need help Dermatology experts!! 

This is a *malignant* lesion of the nose; size is* 23 x 17 mm,* but would you *add *or *multiply* both  after *converting *to *cm *in order to get the 
code selection?  I'm inclined to 11646.  What do you think?

There is no other measurement on the operative report.


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## kbarron (Mar 26, 2008)

*Skin Lesion*

Where did you get the size from? Is it in the MD note? I believe that the size of the lesion should be on the path report. I have to keep my measurments close at hand to convert the mm to cm.


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## elenax (Mar 27, 2008)

I got it from the *post* *surgical notes*.  I work for an *ASC* and we need to code *from *the *Operative Report* and the instructions that we have is to ''base the measurements on the lesion's actual size *before* the surgeon performs the excision and *prior* to sending it to pathology, not according to the size of the surgical wound left behind''.

I would appreciate any help!!


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## heathergirl (Mar 27, 2008)

*little bit of help*

Yes, it must be coded according to the size that is actually removed, not from path report.  This should be in the Dr's progress note.  

Code selection is determined by measuring the greatest clinical diameter of the apparent lesion plus that margin required for complete excision.  Hope that helps.  


Heather D Unklesbay, CPC, MA
Office Manager


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## Erica1217 (Apr 12, 2008)

Yes, the specimens usually shrink from the fluid they are put in for path, correct?  

CPT guidelines state to use the greatest diameter of the lesion PLUS margins as measured by the physician before it is excised.  You do not add or multiply. 

In your case, if that's all the info you have, then you'll have use 23 mm as your measurement.   So that would be 11640. 

 Erica


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## elenax (Apr 14, 2008)

Hi Erica

I am a little bit confused.  I believe the *23mm* needs to be *converted *to *(2.3)cm* before picking up the code...per the *CPT assistant*.  Any feedback please!!


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## efrohna (Apr 14, 2008)

I agree, 23 *milimeters* converted to cm is 2.3 centimeters.  Your CPT should be 11643.  
E. Frohna


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## Erica1217 (Apr 14, 2008)

ha ha ha ha ha.. I'm so dumb!!!   

I did my decimal the wrong way!!!  You guys are right!  Sorry about that!

 Erica


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