Posted on 03. Feb, 2009 by in Hot Coding Topics
Sharpen your lesion coding prowess with this tip from John Bishop: Read the documentation carefully, and pay more attention to the removal’s depth than to the terminology your physician uses.
Technically, any time physician removes skin tissue, he’s performing an “excision.” For coding purposes, however, CPT narrowly defines an excision as involving “full-thickness (through the dermis) removal of a lesion.”
Shaving, in contrast, involves “sharp removal … without a full-thickness dermal excision.” When reporting shaving procedures, you must not consider the size of any margin the physician removes with the lesion. In fact, the physician may not document, or even take, a margin of tissue during a shave. This is a crucial difference from coding for excisions.
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