# Size of a lesion

1. Guest
Posts
19
Size of a lesion
I have a excision of malignant lesion shoulder measuring 3x2.5cm how much cm is this total 7.5?? Or do you just use the 2.5 ?? Confused.....

2. When coding a lesion excision you use the largest diameter documented plus the documeted margin but if the margins are not documented then you can only use the largest documented diameter. In you case that would be 3cm, if the provider also documented that he had say 2cm margins then you add the margins for each side of the lesion so it would be 3 cm(the lesion diameter) + 2cm (the left side margin + 2cm The rt side margin = 7cm total excised diameter.

3. True Blue
Location
NYMAC
Posts
610
Hi Debra,

Why it is only 2sides (RT & LT) why can't we add top & bottom also?

4. Networker
Posts
90
You can only charge going in one direction.
Charging all 4 sides of margins, and the largest diameter would be fraudulent.

You only code the largest of the diameter measurement. In this case the 3cm.
Adding margins to the top and bottom would then mean you are using the smaller diameter - in this scenario that's 2.5

5. Originally Posted by kumeena
Hi Debra,

Why it is only 2sides (RT & LT) why can't we add top & bottom also?
Because you add to each side of fhe largest diameter. Draw youself an oval to represent the elliptical excision. Now make a line from end to end of the largest diameter of the lesion within that oval the space on either side between the lesion and the excision edge is the margin on both sidez of that line.

6. Posts
115
Also, some excision codes (such as 114XX or 116XX) actually state within the code description "excised diameter" not total surface area excised. Diameter is the width, not the total surface area.

Example: Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm

Hope this helps!

7. Posts
5
Converting MM to CM
have a path report with 5x4x4mm how would you convert mm to cm to get the correct CPT?

8. Take the largest diameter and divide by 10. There are 10 mm in a cm.

9. Posts
5
How do you convert mm to cm for a lesion
I have a path report that has 4x5x4mm how would this be converted to cm? Does anyone know where I can find a chart converting mm to cm?

Thank you.

10. True Blue
Location
Baton Rouge
Posts
1,239
Debra's answer above is correct...10mm = 1cm. Divide the diameter of the widest part of the lesion by 10. In your example, it appears to be 5mm, (unless margins are included, in which case read through the previous replies to figure the diameter), which converts to 0.5cm.

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