skin wide excisions

I was instructed in the past that a wide excision of skin with subcutaneous tissue, typically seen in melanoma re-excisions and wide excisions of other skin cancers, should be coded as 88307 (rather than 88305). A recent audit challenged this.
Does anyone have any experience or knowlege with this scenario?

From CAP web site- 88307 sounds right

Q: A 35-year-old BRCA1 mutation-positive patient presented for removal of her right fallopian tube and ovary. (Her left tube and ovary were removed years ago for an ectopic pregnancy.) The tube and ovary were serially sectioned, examined grossly, and embedded in paraffin. Sections from each paraffin block were examined microscopically. No cancer was found. What CPT code should we use?

A: CPT has code 88307, Level V—Surgical pathology, gross and microscopic examination, ovary with or without tube, neoplastic, for a neoplastic ovary and tube and code 88305, Level IV—Surgical pathology, gross and microscopic examination, ovary with or without tube, non-neoplastic, for a non-neoplastic ovary and tube. There is no code specifically for the gross and microscopic evaluation of tissues from patients with a genetic predisposition to neoplasms.

BRCA mutation-positive ovaries submitted for evaluation may require the pathologist to perform the work consistent with an “ovary with or without tube, neoplastic,” or code 88307. In this case, extensive sectioning was performed and the entire specimen was evaluated microscopically, so code 88307 is appropriate. If the organs were not submitted in their entirety, then it would be more appropriate to use code 88305.

88307 skin wide excisions

I was instructed in the past that a wide excision of skin with subcutaneous tissue, typically seen in melanoma re-excisions and wide excisions of other skin cancers, should be coded as 88307 (rather than 88305). A recent audit challenged this.
Does anyone have any experience or knowlege with this scenario?

I guess you didn't like my answer

The difference in the codes appears to be by location and skin is in 88305, not 88307. BUT melanoma is not a skin cancer- it is a cancer of melanocytes and has a huge metastatic potential unlike skin cnacer, so you would have to argue that the work involved fits better in a more complex category than that for a simple skin cancer.

pathology

Code 88305 is appropriate without reading the surgery note and path findings