If you have a prior pathology report indicating malignancy, and the patient is being sent to you for a wider excision (I'm assuming to ensure that all the cancer has been removed), then I would code excision of malignant lesion.
If the patient is being sent to you for the procedure you do NOT have a consult ... it is a transfer of care. If your E/M is significant, separately identifable service from the procedure, then code either a new patient or an existing patient visit (depending on whether the patient has been seen by anyone in your practice and specialty in the last 3 years). Keep in mind that all procedures include an appropriate E/M as part of the RVUs of the procedure.
Hope that helps.
F Tessa Bartels, CPC, CEMC
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