tci General Surgery Coding Alert - 2018 Issue 9

Reader Question: Understand Scalp "and/or" Neck

Question: Our surgeon removed a Merkel cell carcinoma from the scalp. Should we code this as C4A.39, since C4A.4 states “scalp and neck”? Minnesota Subscriber Answer: No, C4A.39 (Merkel cell carcinoma of other parts of face) does not apply to the scalp. Although the forehead is part of the face, the scalp begins on the upper edge of the forehead at the “hairline.” In cases of male-pattern baldness, the differentiation of forehead and scalp is still evident because specific musculature allows the patient to wrinkle or furrow the forehead but not the scalp...

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