In a nutshell: Pt had gastric bypass surgery and now has excess skin of the vulva causing problems. MD says he performed a partial vulvectomy, 56620. I'm thinking it should be coded to 15839, removal of excess skin, and not 56620 because in the Ingenix Px book it says that 56620 is used to remove malignant lesions and the excision of malignancy would require different work then removal of excess skin. Any feedback is appreciated. Thanks!!