General Surgery Coding Alert

Question: How should we code the re-excision of a benign (as opposed to malignant) lesion? The path report indicated suspicious cells, so the surgeon performed a reexcision for border removal. Kentucky Subscriber Answer: The rules for lesion re-excision are the same whether the pathology report returns malignant or benign. If the re-excision occurs during the same operative session as the initial excision (for instance, due to pathology frozen section findings), you should code a single excision. Your size for the code selection should be "based on the final widest excised diameter required for complete tumor removal," according to CPT. If the re-excision takes place at a later session, you'll need to select an excision code the same way you would for the initial excision. For benign lesions, select from codes such as 11400-11446 (Excision, benign lesion including margins, except skin tag [unless listed elsewhere]), trunk, arms or legs; ...) based [...]