The answer to number 1.... Once excision of the in situ neoplasm is complete then the neoplasm is now history of. So the next encounter after the excision is the V10.xx code. When the neoplasm is in situ then there are no invasive components yet, that is what makes it in situ, so excision is definitive therapy and they know it is all gone.
Number 2... I have to say I am a little confused by the question. If you have a dx and excision on the same day and of course they must be two different areas, as you cannot bill for both of the same lesion, the dx code that is first listed should match to the first listed procedure code as a general rule. You do not code the symptoms, only the definitive from the path report. I hope that is the answer you were wanting.
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