tci General Surgery Coding Alert - 2005 Issue 2

You Be the Coder: Include Margins in Lesion Measurement

Question: I've been hearing contradictory advice on how to measure lesions for removal. Should I include the margins? Do I measure the lesion before or after sending the sample to pathology?South Carolina SubscriberAnswer: CPT changed its guidelines for measuring lesions in 2003. Since that time, to determine the total excised diameter, you must calculate the lesion diameter at its widest point (the crucial measurement under the pre-2003 guidelines), plus twice the width of the margin at its narrowest point.For example, the surgeon excises an irregularly shaped, malignant lesion from a patient's left shoulder. The lesion measures 2...

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