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Wiki Skin lesion coding please please HELPpppppp!!

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Savmorton

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Malignant skin lesions question please help not sure if I billed right
A malignant melanoma (skin) of the face measuring 1.0 cm was excised. To ensure all the margins were free of tumor, an additional 2.0 cm was excised from both the top and bottom respectively. Intermediate closure of the resulting 5.5 cm defect was performed.

Is it ok to bill for 11641 & 12053
 
I'm not sure where the extra .5cm came from since 1 + 2 + 2 = 5. Also I don't believe the physician stating it was intermediate closure is sufficient. Typically the note will state the type of suture material, if it was layered, depth etc. There is nothing here to back up the decision that it's intermediate so the closure code

11646 would be the excision since lesion plus margins are over 4cm.
 
CodingKing said:
I'm not sure where the extra .5cm came from since 1 + 2 + 2 = 5. Also I don't believe the physician stating it was intermediate closure is sufficient. Typically the note will state the type of suture material, if it was layered, depth etc. There is nothing here to back up the decision that it's intermediate so the closure code

11646 would be the excision since lesion plus margins are over 4cm.
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Ok thanks so very much. I don't see how I missed the 11646. But yeah the closure is not sufficient enough to code thanks.
 
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