Melanoma History Coding and Surveillance

Clinical Context and Importance

• Patients with a previous melanoma are at moderately increased risk for developing subsequent melanomas and require ongoing surveillance, according to the British Journal of Dermatology 1, 2

Key Documentation Requirements

• The medical record should document original melanoma characteristics, such as tumor thickness, anatomical location, and stage at diagnosis, to guide surveillance intensity, as recommended by the British Journal of Cancer 3, 4
• Treatment received, including wide local excision, sentinel lymph node biopsy, or adjuvant therapy, should be documented, as suggested by the Journal of the National Comprehensive Cancer Network 1, 6

Surveillance Implications Based on Original Stage

• Patients with a history of Stage IA melanoma should be seen 2-4 times over 12 months, then discharged from routine surveillance, according to the British Journal of Dermatology 1, 7
• Patients with a history of Stage IB-IIIA melanoma should have 3-monthly visits for 3 years, then 6-monthly to 5 years, as recommended by the British Journal of Dermatology 1, 7
• Patients with a history of Stage IIIB/IIIC or resected stage IV melanoma should have 3-monthly visits for 3 years, 6-monthly to 5 years, then annually to 10 years, according to the British Journal of Dermatology 1, 7, 8

Risk Stratification Value

• The history code identifies patients who require patient education on self-examination and sun protection, as they remain at elevated risk for developing new primary melanomas throughout their lifetime, as suggested by the British Journal of Dermatology and the British Journal of Cancer 1, 2, 9