Q.2.1: SKIN

For Cases Diagnosed on or after January 1, 2003

C44.0-C44.9

(Except for M-9727, 9732, 9741-9742, 9762-9809, 9832, 9840-9931, 9945-9946, 9950-9967, 9975-9992)

CODING GUIDELINES:

When multiple surgical procedures are done for the treatment of melanoma, follow these instructions to assign surgery codes . See Q.2 for surgery codes.

NOTE:

• Code a Biopsy as Surgery When:

• Shave, punch bx, incisional biopsy or biopsy NOS are most often diagnostic. Code as a surgical procedure ONLY if it removes all of the melanoma. This means when there is no residual tumor present in the re-excision, the biopsy should be coded using surgery codes, not the Dx/Stg codes.  The re-excision is coded as the 2nd procedure and will become the SUMMARY Surg code.

• The biopsy NOS, shave, punch or incisional biopsy and the gross excision do not have to be done as a single procedure to code 30-33.

• Margins must be taken from the pathology report – following CAP (College of     American Pathologists) protocol guidelines.

• To use the codes 45-47, the surgical margins must be >1cm and microscopically negative.

• When there are no margins documented in the pathology report, do not guess/estimate the margin measurements from the specimen size.

• If there are margins for length, width and depth and they are different, code the smallest margin. The smallest margin dictates the surgery code, no matter where it comes from (width, length or depth).

Codes:

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