Dermatology Coding Alert

Question: Our dermatologist's card merely said that he performed a "wide excision" biopsy of sarcoma, without providing any exact measurements. Which excision code should I use?

Rhode Island Subscriber

Answer: First, try discussing the issue with your dermatologist so he understands that location and size determine correct coding for full reimbursement. You might also show him how the monetary reimbursement compares within these codes.

Next, wait to receive the pathology report. If the physician didn't document the location and size, you might be able to get this information from the path report. However, you should understand the limits. Specifically, specimens may shrink when placed in the solutions used to preserve the biopsy. Also, for the integumentary system,  measure the size based on the margin, not just the size of the lesion that is apparent to the naked eye; but the path report may not report the size of the lesion based on the margins.