Forum - Questions & Answers

Sep 3rd, 2009 - TerryC 39 

malignant melanoma coding

My name is Terry, one of my doctors is asking if he can code the following as a malignant melanoma this is the path report (SEVERELY ATYPICAL LENTIGINOUS JUNCTIONAL MELANOCYTIC PROLIFERATION BORDERING ON MELANOMA IN-SITU
EXTENDING WITHIN 3MM FROM NEAREST INKED HISTOLOGIC PERIHERAL MARGIN)
I think the (bordering on melanoma) is what's causing the question. I'm just a coder I don't feel comfortable making this call. I feel this is more of a Dr. call.
However I was asked to check on this. Can anyone help please, Thanks Terry

Sep 3rd, 2009 - nmaguire   2,606 

Borderline

This is a MD decision, borderline is not malignant. Uncertain behavior of the site might be your best choice. With borderline tumors (bordering on malignancy), it is hard to predict whether their future behavior will be benign or malignant. It is not usual for a benign tumor to become malignant, and the majority of cancers do not originate in a benign tumor. Melanocytic benign tumors are the senile lentigo, which can transform into Hutchinson’s melanotic freckle and the blue nevus, formed by melanoblasts which prematurely stop migrating from the neural crest towards the skin, and therefore constitute an example of heterotopia.
The malignant tumors are malignant melanomas. They can derive directly from
elements of the melanogenic system, or arise in one of the nevoblastic or melanocytic lesions. Their progression is rapid, and the very frequent lymphatic invasion is shown by satellite nodules which surround the primary tumor. Regional lymph nodes are rapidly affected, and blood-borne metastases can reach all tissues and organs.



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