Wiki Excision Malignant Lesions

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shypes1953@yahoo.com

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I am really new at this and have a question about excision of malignant lesions. The doctor has noted that she will be doing a wide local excision of the right cheek and right nasal ala with possible rotation flap closure. I don't see any measurements given althought earlier in September, 2010, she has noted that she shaved each of these arease and sent for path. The shave on the right cheek was 1.5 cm excision and the nasal ala was 0.5 cm. Since I don't have measurements on this new excision to be done, would I code range of codes 11640-ll646-RT and 11640-11646-RT-59? I have to code before sending to the hospital. Is the rotation flap (possible) closure bundled in with the code for the excision of rt. nasal ala? Or is this a separate code?
 
You obviosuly cannot code the exact code without the op note. For the excision you have the correct code range, however do not append the RT modifier as this is skin which is one organ without laterality. Also if a flap clousure is performed then you code only the flap closure as the excision is inclusive to the flap closure.
 
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