Wiki Question regarding Excision

[cnramsey]

You will see below the Office note for the excision. I coded 173.22/11641 is this correct? Not sure if I can code the size of the lesion removed by the way the provider has documented.

Patient has recurrent skin lesion right ear after shave excision revealing "squamous proliferation, seborrheic keratosis".

Exam: 6mm raised nodule along edge of right pinna, mid portion. No ulceration.

Procedure: Under 0.5% Marcaine with epinephrine, the lesion was excised down to cartilage and sent to pathology. Wound was closed with 4-0 Ethilon suture. Sterile dressing was applied.

Imp: suspicious skin lesion right ear.

Plan: Written instructions were given. RTO for SR

Path Description of size below
GROSS DESCRIPTION:

The specimen, received in formalin, labeled and designated "
right ear," consists of an unoriented, 1.5 x 0.8 x 0.4 cm ellipse of
gray skin that has an eccentric, 0.4 cm diameter area of ulceration.
The specimen is now inked, sectioned and submitted all in

 

[mitchellde]

your path is not a squamous cell Cancer.. your path is for a seborrheic Keratosis which is a 702.19 with a benign excision code for the 1.5 cm size. The size is documented in the path description and that is acceptable, the codes go by excised diameter not lesion diameter.

 

[cnramsey]

Excision

Here's the rest of the path report. I just sent you the size documented in the Path. We were told we could not code the size of the lesion removed from the path due to shrinkage.

PATHOLOGIC DIAGNOSIS:

Skin lesion, right ear:
- Poorly-differentiated invasive squamous cell carcinoma at base of
biopsy.
- Superficial papillary dermis and epidermis showing features of
nodular basal cell carcinoma.
- Adjacent benign epidermal inclusion cyst with overlying
hyperkeratosis.