# lesion excision



## bwerner (May 24, 2012)

Can someone please help us code this. We keep reading the guidelines and trying to figure it out and got ourselves confused.

Lesion size  2.2cm x 1.5cm
Excision size 3.4c. x 2cm

Thanks!
Becky


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## cwpierce (May 24, 2012)

Code for the Excision size of 3.4cm and by the site of the lesion. Pay attention as to mailgnant or benign.

For a brief explaination: The lesion size is as listed above. Now when adding the narrowest excised margins to the lesion size you get an Excision size as listed above.

Lesion size: 2.2cm x 1.5cm
Margin size: 1.2cm x 0.5cm

Excision size: 3.4cm x 2.0 cm

Hope that helped.


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## BEARDOG (May 24, 2012)

Keep in mind the approach that was used for the excision:

From CPT-Assistant August 2000 pages 5-6



"When an excised lesion is a neoplasm of uncertain morphology (eg, melanoma vs. dysplastic nevi), choosing the correct CPT code relates to the manner in which the lesion is excised, *rather than the final pathologic diagnosis, since the CPT code should reflect the knowledge, skill, time, and effort that the physician invests in the excision of the lesion*.Example: An ambiguous, but low-suspicion lesion might be excised with minimal surrounding, grossly normal skin/soft tissue margins, as for a benign lesion. This would be most appropriately reported using the excision of benign lesion codes 11400-11446. _*An ambiguous, but moderate-to-high suspicion lesion would be excised with moderate to wide surrounding grossly normal skin/soft tissue margins, as for a malignant lesion. This type of excision would be most appropriately reported using the excision of malignant lesion codes 11600-11646."  *_

Your provider must be specific in the documentation there is moderate to high suspicion
that the lesion may be malignant to justify using the 11600-11646 code range. 

While the criteria for measuring the reportable size of the excision and the subsequent code to report has changed since then, I have found no other documentation that indicates a change in the coding concept that was discussed.  I hope you have found this information useful.


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## mitchellde (May 25, 2012)

BEARDOG said:


> Keep in mind the approach that was used for the excision:
> 
> From CPT-Assistant August 2000 pages 5-6
> 
> ...


The moderate to high suspicion is used once the path report is received indicating uncertain behavior not prior to path.  Just wanted to clarify this.


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