Wiki wide excisions

[stogsmom3]

We are having a discussion regarding primary malignant excision and the patient comes back in for a wide excision out side of the global period. The path for the wide excision returns as benign. Do I bill as Malignant cpt and ICD-9 code? Primary path is basal cell and 2nd negative for residual malignancy.

Any help clearing this up would be appreciated.

 

[mitchellde]

you bill as malignancy, the first surgery returned a path as basal cell with positive margins meaning that the areas at the most outside portion of the specimen was positive for malignancy. When those edges were brought together to close the wound in all probability the surgical scar is consistent with malignant neoplasm. The provider will then usually perform a wide excision to get as far outside the outer edges of the malignancy as possible. He is looking for negative margins but is excising out malignancy.

 

[stogsmom3]

Thank you so much Debra! That really helps!