# Shave removal with destruction of benign lesions



## jshelby (May 3, 2017)

The provider documents that the lesion is removed via shave technique, but also is destructed and the lesion is confirmed benign.  We are trying to determine if we should bill the shave removal code (113xx) or benign destruction (17110).   According to NCCI we cannot bill both the shave removal and destruction codes as they are bundled into the destruction.  It seems like it would make more sense to bill for the shave removal than just the destruction.


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## ellzeycoding (May 3, 2017)

If you did a shave removal and destroyed the base, and the lesion was benign, you bill using 11300-11313

If you did a shave removal and destroyed the base, and the lesion was malignant, you bill using a destruction code 17260-17286

If you did a shave removal and did not destroy the base, you bill 11300-11313 regardless if it's malignant or benign


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## kellilynn (Jun 14, 2017)

ellzeycoding said:


> If you did a shave removal and destroyed the base, and the lesion was benign, you bill using 11300-11313
> 
> If you did a shave removal and destroyed the base, and the lesion was malignant, you bill using a destruction code 17260-17286
> 
> If you did a shave removal and did not destroy the base, you bill 11300-11313 regardless if it's malignant or benign



Can you shed light on why we wouldn't bill for a benign destruction in the first scenario?  Per NCCI the removal (13xxx) bundles into the benign destruction code 17110; therefore per NCCI it seems we should bill CPT 17110 instead.  Thank you


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## ellzeycoding (Jun 16, 2017)

kellilynn said:


> Can you shed light on why we wouldn't bill for a benign destruction in the first scenario?  Per NCCI the removal (13xxx) bundles into the benign destruction code 17110; therefore per NCCI it seems we should bill CPT 17110 instead.  Thank you



I understand the confusion and the need for clarification.  This is one of those areas thats a bit "gray" and depending on whom you ask, you can get a different opinion.

Some will say to code to the most *definitive * procedure performed... destruction.  You did a shave removal. You backed it up with curettage of the base and sent the specimen off to path.  a) if it comes back malignant, bill a malignant destruction code (and no shave removal) because ultimately you destroyed it.  b) if it comes back benign, bill a benign destruction code (17110-17111) (and no shave removal because ultimately you destroyed it)

Some will say to code based on the "intent". I intented do a shave removal for therapeutic puroses and bill the 1130X series shave removal codes.

Others will say, that you did a shave removal and sent it off to path. But you destroyed it immediately afterwards. So wouldn't this really be a biopsy?  So why not bill a biopsy and destruction?  Then again these are bundled int he NCCI and you can't do both on the same lesion on the same DOS.   The only exception would be to do a biopsy or shave removal, do an immediate frozen section, and then based on the results and discussion with the patient, decide to destroy it.  So this would be 11100, 17110 or 17260 with 58 modifier for staged procedure) and 88331.


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## dnadinej (Jul 6, 2017)

*11100 vs 11300*

If the documentation specifically states a shave BIOPSY was done but the path report comes back that the lesion was completely removed by the shave, would you bill 11100 or 1130x? I think it should be 11100 but the provider disagrees.


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## ellzeycoding (Jul 6, 2017)

You have to bill using a procedure code that describes the intent of the procedure.  The intent was a biopsy. Bill the biopsy code.


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