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Wiki Coding Excisions and repairs-Please help

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bethh05

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I would like to know if anyone has any clarification for coding excisions. The physicians here are not the best at dictating sizes of lesions, when I queried the physicians office I was told to please refer to the path report. I have been doing that, I would just like to know how everyone else in this predicament is coming up with the sizes for instance the path report states: "The specimen consists of an unoriented skin ellipse measuring 1.3x0.7x0.4cm. The epidermal surface is tan with a centrally located depressed lesion measuring 0.3cm in diameter." The CPT manual states the greatest diameter of the apparent lesion plus that margin required for complete excision.

Also for layered repairs the physician dictates he excised a lesion with layer closure(4.7mm x 62mm). I have been adding these 2 sums together for the total repaired. Does anyone know if this is correct? Any help would be greatly apprectiated. Thank You very much!!
 
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Code based on the greatest diameter of the lesion plus margin, 1.3 cm in your example. The physician should make this measurement prior to the procedure. If he/she is not, your way seems like the best you can do thougjh I'm not sure if it's technically correct.

My understanding of the closure is to code the total length in a linear closure. In your example it would be 6.2 cm.

That's my opinion. Hope it helps.
 
Once you have the path size you already have the margins included. If the physician does not measure this for you prior to sending it to path then you will have to use the specimen size as your excision size. SO base your excision on 1.3cm, and the repair as 6.2cm
 
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