# excision of 2 lesions in one incision



## lindaj0317 (Jan 22, 2015)

the pt came in with a bx proven SCC and when the Dr was removing it via excision she also saw a lipoma that she also removed from the same incision.
Can we bill both the malignant exc code 11603 and the benign exc code 11402 for this even when only one excision was done?  I think that we can't but want some imput.
thanks for any help with this.


----------



## mitchellde (Jan 22, 2015)

lindaj0317 said:


> the pt came in with a bx proven SCC and when the Dr was removing it via excision she also saw a lipoma that she also removed from the same incision.
> Can we bill both the malignant exc code 11603 and the benign exc code 11402 for this even when only one excision was done?  I think that we can't but want some imput.
> thanks for any help with this.



The provider only performed one excision and that is all that can be billed.  Even though two abnormality were removed it was one excision.  You charge by the the excised diameter not by the lesion size.


----------



## JesseL (Jan 22, 2015)

mitchellde said:


> The provider only performed one excision and that is all that can be billed.  Even though two abnormality were removed it was one excision.  You charge by the the excised diameter not by the lesion size.



Hmm.. would she still go with the malignant excision code though in that case?  Factoring in the excised diameter of the benign lipoma with the malignant lesion together?


----------



## mitchellde (Jan 22, 2015)

You would use both dx codes the diameter would be equal to the excised diameter regardless of the lesion size.  The provider must document the size of the excision in this case before it can be coded . And yes go with the malignant excision code.


----------



## Bhargavaraopodapati (Feb 28, 2017)

mitchellde said:


> You would use both dx codes the diameter would be equal to the excised diameter regardless of the lesion size.  The provider must document the size of the excision in this case before it can be coded . And yes go with the malignant excision code.



this is bhargava

we have to take the diameter of entire incision or diameter of the malignant lesion. please clarify


----------



## ellzeycoding (Mar 2, 2017)

Excisions are measured by the initial lesion size PLUS margins use to cut around it.  So basically the overall excision size *including *the margins.

In this simple pic, a 1.0 cm lesion is excised with 0.2 cm on each side.  1.0 + 0.2 + 0.2 = 1.4 cm excised diameter


----------



## CatchTheWind (Mar 3, 2017)

So glad to see you on the forum, Karl!  Your expertise will be much appreciated here.


----------



## hunters (Nov 20, 2018)

*excision 5 lipoma's thru 3 incisions*

I have a similar scenario except these are deep subcu lipoma's that were excised.  5 lipoma's excised from 3 incisions.  2 of the lipoma's were so close to the other lipoma's that he just extended his incision to extract 2 lipoma's from 1 incision.....2 lipoma's from the 2nd incision.....and 1 lipoma from the 3rd incision.   I believe we can only bill for 3 excisions but some of my coworkers believe we can bill for all 5.  Your thoughts would be greatly appreciated!! Thank ya kindly,

Sharon Hunter, CPC, CGSC


----------



## CatchTheWind (Dec 3, 2018)

You can only bill for three.


----------

