# ear lesion



## Ksumansky (Jan 16, 2009)

Hello, I am not sure on the coding with the following scenario.  Any help would be appreciated.

The lesion (chondrodermatitis nodularis helicis) of the helical rim was excised in a wedge-like fashion. After hemostasis was obtained bilateral contracutaneous advancement flaps were elevated for coverage. 

I am not sure if you can code 69110 and 14060. Or just 14060 since usually lesion excision is included in that code.  
Thank you for you help.


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## scadykat (Jan 16, 2009)

Hi,
You should be able to bill 14060 & 69110 (in that order). Each of the procedures should be clearly documented.


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## jackjones62 (Jan 16, 2009)

Hello, I disagree, 69110 and 14060 should not be billed together; these are 2 separate procedures that both include an excision and repair; after reading your "op note" descriptive, CPT 69110 is your best choice, this is usually a wedge excision with layered closure; your physician advanced the two sides to complete the repair, usually requiring layered sutures.  If you read the guidelines for 14060, this includes the excision of lesion and/or repair by adjacent tissue transfer, and it goes on to describe the tissue transfers and rearrangements.  I usually utilize this code when the documentation clearly indicates that significant plastic repair has been done with the plasties and flaps as described.

Hope this helps.

Jennifer 
ENT in CT


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## Treetoad (Jan 16, 2009)

I agree with Jennifer.  The excision would be included in the adjacent tissue transfer.


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