AHA Coding Clinic® for HCPCS - 2013 Issue 1; ASK the EDITOR

Radical excision vs. wide excision

Patient had a previous excisional biopsy of the mid-upper back. This proved to be a poorly differentiated possibly metastatic desmoplastic spindle cell melanoma into the soft tissues of back. The patient now presents to have excision of the scar and surrounding tissue, subcutaneous tissue and fascia overlying the muscle in order to adequately control the disease. The 13 cm x 2 cm wound was closed in layers with buried dermal sutures, skin closed with 4-0 Monocryl with Dermabond also being utilized. Pathology report shows seborrheic keratosis with no residual spindle cell malignancy identified. Would this be considered a radical excision or a wide excision of a previous scar?  ...

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