tci General Surgery Coding Alert - 2010 Issue 2

READER QUESTIONS: Diagnosis Doesn't Change Re-Excision

Question: How should we code the re-excision of a benign (as opposed to malignant) lesion? The path report indicated suspicious cells, so the surgeon performed a reexcision for border removal. Kentucky Subscriber Answer: The rules for lesion re-excision are the same whether the pathology report returns malignant or benign. If the re-excision occurs during the same operative session as the initial excision (for instance, due to pathology frozen section findings), you should code a single excision. Your size for the code selection should be "based on the final widest excised diameter required for complete tumor removal," according to...

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