# Trunk versus Extremity



## NESmith (Jun 8, 2010)

Our Dermatologist did a excision with complex layered repair of a basal cell carcinoma of the right shoulder.

Billed: 11602(excision malignant lesion including margins trunk, arms/or legs excised diameter 1.0 to 2.0cm)the tissue defect maximum width of 1.5 cm of the right shoulder. 
13121(Repair; complex scalp arms/or legs 2.6 cm to 7.5 cm)The length of the final closed defect was 4.5 cm.

The insurance company is denying the closure because they state the description of the closure does not match the excision. 

My question is the insurance company looking at the shoulder as being part of the trunk and the doctor is considering the shoulder the arm? 
Please help. thanks


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## Ksumansky (Jun 10, 2010)

In my opinion I would of used cpt 13101 (complex repair: trunk) for the closure.  I have always coded shoulder lesions as trunk.  

Hope this helps......


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## jgf-CPC (Jun 14, 2010)

I agree with Kelly we also used trunk


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