Answer: The key difference between coding for skin and bladder lesion removal is the role of the wide margin in determining the size of the lesion.
The 2003 CPT skin lesion measurement guidelines indicate that the diameter of a lesion is calculated by adding the diameter of the lesion and the sizes of the margins. Calculating the measurement of bladder lesions, however, is strictly limited to the diameter of the lesion or tumor itself, not including the wide margins. Typically, the urologist will cauterize the entire area around the tumor, and according to CPT guidelines , the entire area of cautery is not to be included in the measurement of the bladder lesion.
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