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Wiki Squamous/Basal cell carcinoma, multiple site of skin

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atipton12

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I always have difficulty determining the best ICD9 code for the following scenario:

Specimen A- skin excision of right lateral temple with dx of invasive basal cell carcinoma
Specimen B- skin excision of scalp with dx of invasive squamous cell carcinoma
Specimen C-skin excision of shoulder with dx of squamous cell carcinoma in situ

I'd like to believe this is appropriate to code
173.31
173.42

I feel like I should not code 173.81 and 173.82 for other specified site of the skin since I know the specific site. But do I apply the code for the specific type of carcinoma and site for each site? Sometimes I may even received even more sites than 2 or 3. I am lead to believe that I do not code for the in site since I have invasive identified although the in situ is a 3rd site.

Is there a rule of thumb for this scenario?
 
You should do as you have done and code each individual site when possible, I would add to what you have there the 232.6 for the shoulder.
then you would have the basal cell of the face - 173.31
squamous cell of the scalp - 173.42
squamous cell of the shoulder insitu - 232.6
You have two different types of invasive cancer in two different places and you have one insitu in a totally different location.
 
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