Melanoma synoptic question (urgent please)

[bioguy]

A shave biopsy shows melanoma extending to margin, synoptic is reported, at least 1mm thickness, no LVI.

The re-excision shows residual melanoma, less than 1 mm thickness, LVI is present. The pT stage doesn't change. Does this require a (re)synoptic or do I just report the differences.

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[jp123ok]

We would just report the differences.

 

[icpshootyz]

In the past I would say just report the differences, but our billing company keeps hounding me to do synoptics on anything called melanoma (they always also send me back MMIS cases for synoptics, which I politely inform them is nonsensical). I think it's a PQRS thing. So if you don't do the synoptic over you might be missing out on a miniscule amount of reimbursement from CMS. But yes, for actual diagnosis purposes just reporting the differences and mentioning that the stage remains the same is perfectly fine.

 

[bioguy]

Thanks all.

It is primary. And I already confirmed LVI with IHC.