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Otolaryngology Coding Alert

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Radical Resection of Malignant Ear Melanoma with FTSG

Published on Wed May 09, 2012

Question: How should I code a radical resection of malignant ear melanoma with full-thickness skin graft (FTSG). The excision size measured 4.5 cm, and the FTSG was more than 10 sq cm. Should I use an excision code and also charge the graft harvesting?Missouri SubscriberAnswer: Yes, you should code the graft in addition to the excision. "When a primary procedure such as ... deep tumor removal requires skin graft for definitive closure, see the appropriate anatomical subsection for primary procedure and this section [15002-+15278] for skin graft or skin substitute," state CPT's Skin Replacement Surgery and Skin Substitutes introductory notes.Look to 11600-11646 for the malignant lesion excision code (radical resection of malignant ear melanoma). Similar to the graft codes, CPT breaks the excision codes into anatomic and size families. For a 4.5-cm malignant lesion excision from the ear, use 11646 (Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; [...]
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