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Wiki GYN CA in-situ

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jlsurology01

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We have a patient that the doctor did an excision on but it is being denied as not covered/not medically necessary. The doctor and I are wondering if the code should be 11646 instead of 11426. Doctor is unclear since she can not say definitively that it is an invasive ca. (icd9 233.32)
 
Do you have a path report indicating CA in situ? Ca insitu is a malignancy that has no invasive components... Yet. If the path states CA in situ then you use malignant excision codes. I am confused when you state the physician cannot state if it is invasive. The path tells the provider it is not invasive. .
 
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