General Surgery Coding Alert

Question: When the surgeon excises a skin lesion and the pathology report returns as Merkel cell carcinoma, we've always reported 173.x (Other malignant neoplasm of skin). I've heard there is a new ICD-9 code for this condition -- what is the proper code? Georgia Subscriber Answer: ICD-9 provides six new codes specific for Merkel cell carcinoma based on body site: • 209.31 -- Merkel cell carcinoma of the face • 209.32 -- ... of the scalp and neck • 209.33 -- ... of the upper limb • 209.34 -- ... of the lower limb • 209.35 -- ... of the trunk • 209.36 -- ... of other sites. "Other" is not unspecified: ICD-9 coding convention differentiates codes for "other sites" -- which means other specified sites -- and "unspecified" -- often referred to as "not otherwise specified" (NOS) or unknown site. Coupled with the initial ICD-9 committee recommendation for 209.75 (Merkel cell carcinoma, unknown primary site), there was some confusion [...]