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Excision malig. melanoma 11640 vs 27615

  1. #1
    Default Excision malig. melanoma 11640 vs 27615
    Medical Coding Books
    I seem to run into this alot. Wide local excision of maligant melanoma of left leg. I have trouble between the 11640 codes with layered closure and the 27615 code. I see this alot and the Dr. always want the 27615 code. His op notes read: Both were excised after delineating
    an elliptical incision around both with adequate gross margins. The areas
    were then infiltrated and taken with a knife down to the fascia with
    excisions measuring 2 x 1 cm proximally and 4 x 3 cm distally. Both sites
    were closed in a multiple layer fashion with 3-0 PDS and dressings were
    applied including Xeroform.

    Thank you for your help

  2. #2
    because he is taking it down to the fascia, I believe the 27615 code is the correct code.

    Its important to look at the depth of the incision/excision as they are not always going to be from the integ section.

  3. #3
    Thank you, that's what I was thinking.

  4. Default
    I could be wrong in my thinking, but unless he went into the muscle/fascia, I would stick with the skin/subcutaneous codes. According to this documentation, he's only going down to the fascia (unless I'm missing something). Again, I might be a little too conservative.


  5. #5
    The 27615 is for soft tissue. The other alternative is 27618 which is sub-q.

    You read it correctly is only "down to" the fascia so it still qualifies for a code outside the integ section.

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