# Excision of skin lesion



## Mohana Prasad (Nov 12, 2009)

Hi:

Can anyone explain the dimension 2.0 x 1.1 x 0.8 cm which is documented for the excision of single skin lesion. Is 2.0 is the real diameter of the lesion alone and 1.1 & 0.8 is the length of the margins?

Also if the patient had muliple lesions on the same anatomical area (Eg:Trunk two lesions 2cm & 1cm) and all the lesions were excised. Can we sum up all the diameter (3cm) and code only one code (11403) or should we code each lesion seperately with modifier 59 (11402, 11401-59).

Thanks & Regards,
N. Mohana Prasad.


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## mitchellde (Nov 12, 2009)

most excisions are eliptical so you have a length a width and a depth measue, you use the largest diameter.  You Never add the excisions together you code each one separate using 59 modifier.


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## Mohana Prasad (Nov 12, 2009)

Thanks for your assisstance Debra.


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## banumathy (Nov 13, 2009)

Hi Debra,

our surgeon removes the callus around the wound and then debrided the s/q tissue. Kindly advice can we bill callus removal(11055) separately?

In E&M visit, doctor removes the lot of scabs and scales of wound using blade. kindly advice can we consider as selective debridement and code 97597?

Also in office setting can we use HCPCS(A4550) code for "forceps & #15 blade" separately?

please advice


Banu


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## mitchellde (Nov 13, 2009)

You may not bill separately for surgical supplies that are an inherent and necessary part of the surgical service.  As far as can you bill certain debridement and removal codes I really cannot answer without seeing the documentation.  My answer then is possibly depending on the documentation.


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