June 6, 2019

Question:

A pathology report came back from a skin biopsy stating “compound dysplastic lesion with severe atypia.  Re-excision recommended.”  Should the diagnosis code be D48.5 for lesion of uncertain behavior of the skin be assigned, or a benign code since it does not state it is malignant?

Answer:

Since the pathology notes the lesion to be dysplastic with severe atypia and is recommending re-excision, ICD-10-CM code D48.5 is appropriate.

*This response is based on the best information available as of 06/06/19.