Wiki 88304 vs. 88305

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irishhawk

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Hello all! I'm brand-spankin' new to derm path coding. I have a good mentor here in the office; but she's not always available. Can anyone recommend a reference to use to help decide where a diagnosis fits ? As an example, what about an Eschar?
My basic rules thus far; cicatrix/cyst/skin tags/abcess/lipoma/wounds unless from a previous biopsy are 88304s.
Every day I see more and more skin problems and know I'll need a good resource.
Thanks in advance!
Megan, CPCHa
 
I have the coding handbook as well, but I have found the scar section to be vague at best. I also have questions.

Dx: Dermal scar and mixed inflammatory infiltrate.
Micro: These are nonspecific findings, but they may represent the sequela of a ruptured epidermoid cyst, although no cyst wall or its contents are identified."

Would this be an 88305 as I do not believe it is a simple scar or 88304 because it "may represent the sequela of a ruptured epidermoid cyst?" :confused:
 
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Indeed, even the handbook doesn't cover every situation. :( We continue to struggle with some bone specimens, but that's another topic.

For this case, I agree. I would code this 88305 and use the diagnosis codes of 709.2 and 686.9, as long as it wasn't a reexcision of a previously diagnosed lesion. The micro confirms non-specific findings and says "MAY represent," which is also non-specific.
 
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