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skin lesion measurement

  1. #1
    Default skin lesion measurement
    Medical Coding Books
    Need help Dermatology experts!!

    This is a malignant lesion of the nose; size is 23 x 17 mm, but would you add or multiply both after converting to cm in order to get the
    code selection? I'm inclined to 11646. What do you think?

    There is no other measurement on the operative report.

  2. #2
    Seacoast- Dover New Hampshire
    Default Skin Lesion
    Where did you get the size from? Is it in the MD note? I believe that the size of the lesion should be on the path report. I have to keep my measurments close at hand to convert the mm to cm.
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  3. #3
    I got it from the post surgical notes. I work for an ASC and we need to code from the Operative Report and the instructions that we have is to ''base the measurements on the lesion's actual size before the surgeon performs the excision and prior to sending it to pathology, not according to the size of the surgical wound left behind''.

    I would appreciate any help!!

  4. #4
    Daytona Beach
    Default little bit of help
    Yes, it must be coded according to the size that is actually removed, not from path report. This should be in the Dr's progress note.

    Code selection is determined by measuring the greatest clinical diameter of the apparent lesion plus that margin required for complete excision. Hope that helps.

    Heather D Unklesbay, CPC, MA
    Office Manager

  5. #5
    Yes, the specimens usually shrink from the fluid they are put in for path, correct?

    CPT guidelines state to use the greatest diameter of the lesion PLUS margins as measured by the physician before it is excised. You do not add or multiply.

    In your case, if that's all the info you have, then you'll have use 23 mm as your measurement. So that would be 11640.


  6. #6
    Hi Erica

    I am a little bit confused. I believe the 23mm needs to be converted to (2.3)cm before picking up the code...per the CPT assistant. Any feedback please!!

  7. #7
    I agree, 23 milimeters converted to cm is 2.3 centimeters. Your CPT should be 11643.
    E. Frohna
    Evangelina Frohna, CPC, CEMC

  8. #8
    ha ha ha ha ha.. I'm so dumb!!!

    I did my decimal the wrong way!!! You guys are right! Sorry about that!


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