Excision, malignant lesion, trunk, arms, or legs; lesion diameter 0.6 to 1.0 cm (11601) Excision, malignant lesion, trunk, arms, or legs; lesion diameter 1.1 to 2.0 cm (11602) Excision, malignant lesion, trunk, arms, or legs; lesion diameter 2.1 to 3.0 cm (11603)
Full Answer
Melanoma, skin of leg ICD-10-CM C43.70 is grouped within Diagnostic Related Group (s) (MS-DRG v38.0): 595 Major skin disorders with mcc 596 Major skin disorders without mcc
Codes C43 Malignant melanoma of skin C43.0 Malignant melanoma of lip C43.1 Malignant melanoma of eyelid, including canthus
This type of excision would be most appropriately reported using the excision of malignant lesion including margins codes 11600- 11646. Notice: It is not appropriate to bill Medicare for services that are not covered (as described by the entire LCD) as if they are covered.
ICD-10 code C43. 9 for Malignant melanoma of skin, unspecified is a medical classification as listed by WHO under the range - Malignant neoplasms .
1: Open wound of thigh.
ICD-10 code C43. 71 for Malignant melanoma of right lower limb, including hip is a medical classification as listed by WHO under the range - Malignant neoplasms .
9: Malignant melanoma of skin, unspecified.
ICD-10-CM Code for Unspecified open wound, right thigh S71. 101.
The types of open wounds classified in ICD-10-CM are laceration without foreign body, laceration with foreign body, puncture wound without foreign body, puncture wound with foreign body, open bite, and unspecified open wound. For instance, S81. 812A Laceration without foreign body, right lower leg, initial encounter.
D03. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
Group 1CodeDescriptionD03.60Melanoma in situ of unspecified upper limb, including shoulderD03.61Melanoma in situ of right upper limb, including shoulderD03.62Melanoma in situ of left upper limb, including shoulderD03.70Melanoma in situ of unspecified lower limb, including hip79 more rows
ICD-10 code: K57. 92 Diverticulitis of intestine, part unspecified, without perforation, abscess or bleeding.
ICD-10 Code for Atherosclerotic heart disease of native coronary artery without angina pectoris- I25. 10- Codify by AAPC.
ICD-10 Code for Malignant melanoma of other part of trunk- C43. 59- Codify by AAPC.
A primary malignant neoplasm that overlaps two or more contiguous (next to each other) sites should be classified to the subcategory/code .8 ('overlapping lesion'), unless the combination is specifically indexed elsewhere.
All neoplasms are classified in this chapter, whether they are functionally active or not. An additional code from Chapter 4 may be used, to identify functional activity associated with any neoplasm. Morphology [Histology] Chapter 2 classifies neoplasms primarily by site (topography), with broad groupings for behavior, malignant, in situ, benign, ...
Merkel cell carcinoma ( C4A.-) sites other than skin-code to malignant neoplasm of the site. Malignant melanoma of skin. Approximate Synonyms. Malignant melanoma of skin of cheek. Malignant melanoma of skin of chin. Malignant melanoma of skin of eyebrow. Malignant melanoma of skin of forehead.
The Table of Neoplasms should be used to identify the correct topography code. In a few cases, such as for malignant melanoma and certain neuroendocrine tumors, the morphology (histologic type) is included in the category and codes. Primary malignant neoplasms overlapping site boundaries.
A primary malignant neoplasm that overlaps two or more contiguous (next to each other) sites should be classified to the subcategory/code .8 ('overlapping lesion'), unless the combination is specifically indexed elsewhere.
All neoplasms are classified in this chapter, whether they are functionally active or not. An additional code from Chapter 4 may be used, to identify functional activity associated with any neoplasm. Morphology [Histology] Chapter 2 classifies neoplasms primarily by site (topography), with broad groupings for behavior, malignant, in situ, benign, ...
Merkel cell carcinoma ( C4A.-) sites other than skin-code to malignant neoplasm of the site. Malignant melanoma of skin. Approximate Synonyms. Malignant melanoma of skin of bilateral feet. Malignant melanoma of skin of bilateral hips. Malignant melanoma of skin of bilateral lower limbs. Malignant melanoma of skin of right foot.
The Table of Neoplasms should be used to identify the correct topography code. In a few cases, such as for malignant melanoma and certain neuroendocrine tumors, the morphology (histologic type) is included in the category and codes. Primary malignant neoplasms overlapping site boundaries.
Secondary malignant melanoma of skin. Superficial spreading malignant melanoma of skin. Clinical Information. A primary melanoma arising from atypical melanocytes in the skin.
The Table of Neoplasms should be used to identify the correct topography code. In a few cases, such as for malignant melanoma and certain neuroendocrine tumors, the morphology (histologic type) is included in the category and codes. Primary malignant neoplasms overlapping site boundaries.
A primary malignant neoplasm that overlaps two or more contiguous (next to each other) sites should be classified to the subcategory/code .8 ('overlapping lesion'), unless the combination is specifically indexed elsewhere.
All neoplasms are classified in this chapter, whether they are functionally active or not. An additional code from Chapter 4 may be used, to identify functional activity associated with any neoplasm. Morphology [Histology] Chapter 2 classifies neoplasms primarily by site (topography), with broad groupings for behavior, malignant, in situ, benign, ...
Epidermal layer only. Malignant melanoma is malignant neoplasm of melanin (brown pigment producing) cells, described as having invaded the dermis or as one of the following stages: Stage I – Localized. Stage IA – Less than 1.0 mm thick, no ulceration, no lymph node involvement, no distant metastases.
In ICD-9-CM, Category 172 is specific to general body sites and includes both malignant melanoma that has invaded deeper layers of skin beyond the top layer and melanoma in situ (Stage 0, top layer of skin only).
Patients with melanoma in situ are classified as TIS (tumor in situ). The tumor is limited to the top layer of the skin (epidermis) with no evidence of invasion of dermis, surrounding tissues, lymph nodes or distant sites. Melanoma in situ presents very low risk for recurrence or metastasis.
Lauri Gray, RHIT, CPC, has worked in the health information management field for 30 years. She began her career as a health records supervisor in a multi-specialty clinic. Following that she worked in the managed care industry as a contracting and coding specialist for a major HMO. Most recently she has worked as a clinical technical editor of coding and reimbursement print and electronic products. She has also taught medical coding at the College of Eastern Utah. Areas of expertise include: ICD-10-CM, ICD-10-PCS, ICD-9-CM diagnosis and procedure coding, physician coding and reimbursement, claims adjudication processes, third-party reimbursement, RBRVS and fee schedule development. She is a member of the American Academy of Professional Coders (AAPC) and the American Health Information Management Association (AHIMA).
CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
This First Coast Billing and Coding Article for Local Coverage Determination (LCD) L33818 Excision of Malignant Skin Lesions provides billing and coding guidance for frequency limitations as well as diagnosis limitations that support diagnosis to procedure code automated denials.
All those not listed under the “ICD-10 Codes that Support Medical Necessity” section of this article.
Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.
Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.
A primary malignant neoplasm that overlaps two or more contiguous (next to each other) sites should be classified to the subcategory/code .8 ('overlapping lesion'), unless the combination is specifically indexed elsewhere.
All neoplasms are classified in this chapter, whether they are functionally active or not. An additional code from Chapter 4 may be used, to identify functional activity associated with any neoplasm. Morphology [Histology] Chapter 2 classifies neoplasms primarily by site (topography), with broad groupings for behavior, malignant, in situ, benign, ...
To select an appropriate code for excision of a benign (11400-11471) or malignant (11600-11646) skin lesion, you must determine the lesion’s diameter at its widest point, and add double the width of the narrowest margin (the portion of healthy tissue around the lesion also excised).
This holds true even if the pathology report on the second excision returns benign because the reason for the re-excision was malignancy. Treat each skin lesion excision as a separate procedure, with an individual, dedicated diagnosis.
Example: A surgeon excises an irregularly shaped, malignant skin lesion from a patient’s right shoulder. Prior to excision, the lesion measures 1.5 cm at its widest. To ensure removal of all malignancy, the surgeon allows a margin of at least 1.5 cm on all sides.
John Verhovshek, MA, CPC, is a contributing editor at AAPC. He has been covering medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University.