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Wiki wide excision

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vkratzer

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We have a patient that had an excision of a malignant melanoma of the back. The pathologist recommended re-excision since the lesion extended to the margin of the excision. The re-excision was down to the level of the muscular fascia and required layer closure. Would it be appropriate to use 21930 even though the pathology did not reveal any residual tumor. Thanks for your help.

Vicky
 
That is the way I would code it, however, it also depends on what you coded the original excision. I would also add modifier - 58.

I would like to see what everyone else is doing. This comes up quite a lot at our practice.

Zina
 
Excision - Re-excision

For reference to re-excision procedure, see page 55 in the 2009 CPT manual (Excision - Malignant Lesions). I'm not sure how this was originally billed but I hope this helps.
 
Re-excisions

How do we code re-excisions? Do we only code the additional margins that were taken or do we code both the scar and margins?
Ex: Scar was 2.5 cm and 5 mm margins were taken. What is my total?

Thank you, Marci Klaubauf, CPC
 
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