# multiple lesion/tumor excisions



## diann (May 10, 2011)

I have a surgeon who dictated in his OP Report "multiple (20 or 30) lesions excised from both RT upper arm and LT Forearm".  I sent it back stating I needed sizes and a count--how many from each arm.  His office is saying that they coded it with one code with all the sizes lumped together (stating the 10% of body).  I'm saying this isn't right.  Am I wrong?
I thought it was they are coded separately unless they are submitted to pathology as one specimen.
Any guidance would be greatly appreciated.
Thanks
Diann DoBran CPC CPC-H


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## nsteinhauser (May 11, 2011)

Code each excision separately.  You wouldn't code them as one  - "lumped all together" -  unless the surgeon excised just one piece of skin that encompassed/included ALL the multiple lesions.  In the cpt book under the "Excision - benign lesions" header it states "Report separately each benign lesion excised."  

There are some 'destruction' codes that include multiples like '15 or more' under one code. Was the physician's office referring to those? 

Hope this helps.


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## surgonc87 (May 11, 2011)

Don't forget to mention that the repair may be added together and reported with one code, same body area described by the code(and any add on code).  Each excision is reported separately to the greatest diameter.  Supporting information on that is in the book itself and you can pull up articles to state your claim...sometimes our words are not enough especially when we are new to a group...

HOpe that helps mS


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## mitchellde (May 11, 2011)

without the operative report how do you know these "removals" were excisions?  they must be a removal of the visible anomaly to a depth of full thickness to be an excision.  They may in fact have been destructions or shaving.  So without an op note there is not way to know how to properly code this.


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## Peter Davidyock (May 12, 2011)

I am somewhat doubtful that these were 20 to 30 "excisions".
That is an enormous amount for one session.
More than likely some form of cryo or laser destruction.
Ask the staff how it was performed and you'll have your answer.


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## diann (May 12, 2011)

Thanks to all of you, I really appreciate it.  I was getting flack for sending the Op report back for clearer dictation.  I felt I was right but started to doubt myself, so that's why I was asking for input.  I really do appreciate it....so far I haven't gotten the dictation back and it's been three weeks soooo.....  Thanks again!
Diann DoBran CPC CPC-H


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