Excision malig. melanoma 11640 vs 27615

MEZIESKY

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I seem to run into this alot. Wide local excision of maligant melanoma of left leg. I have trouble between the 11640 codes with layered closure and the 27615 code. I see this alot and the Dr. always want the 27615 code. His op notes read: Both were excised after delineating
an elliptical incision around both with adequate gross margins. The areas
were then infiltrated and taken with a knife down to the fascia with
excisions measuring 2 x 1 cm proximally and 4 x 3 cm distally. Both sites
were closed in a multiple layer fashion with 3-0 PDS and dressings were
applied including Xeroform.

Thank you for your help
Marie
 

mbort

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because he is taking it down to the fascia, I believe the 27615 code is the correct code.

Its important to look at the depth of the incision/excision as they are not always going to be from the integ section.
 

Treetoad

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I could be wrong in my thinking, but unless he went into the muscle/fascia, I would stick with the skin/subcutaneous codes. According to this documentation, he's only going down to the fascia (unless I'm missing something). Again, I might be a little too conservative.
 

mbort

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The 27615 is for soft tissue. The other alternative is 27618 which is sub-q.


You read it correctly Treetoad..it is only "down to" the fascia so it still qualifies for a code outside the integ section.
 
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