jyoung
Contributor
I have a coding question, I am hoping you can assist. My physician's experience has been that a keratoacanthoma is a variant of a squamous cell carcinoma (i.e., malignant), so excision of keratoacanthomas would be coded as an excision of a malignant lesion, subtyped by location and size.
ICD10 officially lists "keratoacanthoma" as a BENIGN "thickening of the skin", thus medicare (and insurers) would code as a benign excision. Here is a link to some discussion of this topic through AAPC: https://www.aapc.com/memberarea/for...mous-cell-carcinoma-epidermal-thickening.html.
The pathologist we use (a certified dematopathologist) always reports on whether the margins of a keratoacanthoma are clear or not, which he does only with malignant lesions, not benign lesions. Coders at our office are telling us this is a benign excision.
What do you think? Do you think it would be as simple as having the pathologist report it as "keratoacanthoma variant of squamous cell carcinoma" on the report, to show in case of audit? Thank you for your feedback!
ICD10 officially lists "keratoacanthoma" as a BENIGN "thickening of the skin", thus medicare (and insurers) would code as a benign excision. Here is a link to some discussion of this topic through AAPC: https://www.aapc.com/memberarea/for...mous-cell-carcinoma-epidermal-thickening.html.
The pathologist we use (a certified dematopathologist) always reports on whether the margins of a keratoacanthoma are clear or not, which he does only with malignant lesions, not benign lesions. Coders at our office are telling us this is a benign excision.
What do you think? Do you think it would be as simple as having the pathologist report it as "keratoacanthoma variant of squamous cell carcinoma" on the report, to show in case of audit? Thank you for your feedback!