Wiki GYN CA in-situ

[jlsurology01]

We have a patient that the doctor did an excision on but it is being denied as not covered/not medically necessary. The doctor and I are wondering if the code should be 11646 instead of 11426. Doctor is unclear since she can not say definitively that it is an invasive ca. (icd9 233.32)

 

[mitchellde]

Do you have a path report indicating CA in situ? Ca insitu is a malignancy that has no invasive components... Yet. If the path states CA in situ then you use malignant excision codes. I am confused when you state the physician cannot state if it is invasive. The path tells the provider it is not invasive. .