# need help - I could use some help



## kdm (Jul 23, 2009)

I could use some help. I don't work for dermatology but we are doing more lesions.   The doctor removed 3 lesions form the scalp area.  They were removed with surgitron, coated with bacitracin ointment.  Do I add the three lesion sites a 3mm, 1mm and 4mm together and code as one or code each one seperate.  km


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## LCRUZ515 (Jul 30, 2009)

It depends on what type of lesion it is. If this was a benign lesion you would just use the 17110 code. If this was a melignant lesion you would add them and use the destruction of malignant lesion code (17271) for scalp 6mm -10mm long.


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## kdm (Aug 26, 2009)

*what about*

Thanks for the help.   What about the 11300's.  I am new to this office but it looks as if they have been using that series for removal with surgitron.    km


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## mitchellde (Aug 26, 2009)

LCRUZ515 said:


> It depends on what type of lesion it is. If this was a benign lesion you would just use the 17110 code. If this was a melignant lesion you would add them and use the destruction of malignant lesion code (17271) for scalp 6mm -10mm long.


I do not mean to sound critical but no you never add the lesion sizes together for a destruction or a removal.  also the sizes given were in mm and the codes are in cm.  For the example given if it were a malignant destruction you would have 
17270
17270 59
17270 59
for a shave removal it would be
11300
11300 59
11300 59
for lesions you code each lesion independent, unless of course you are using the 17110 code and covers up 14 lesions.


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## kdm (Aug 27, 2009)

*What about*

Thank you for the help.  I know not to add together lesions but was unsure if shave ( the 11300's was any different ).  The doctor usually uses mm and we have to convert to cm.  

 I do have an additional question.  When he does more than one lesion using the advancement flap (section 14000's )Adjacent Tissue Transfer or Rearrangement isn't each lesion excision coded?  

 Example_     .7sq cm lesion on chin                14040 
                  10.2 sq cm lesion on forehead      14041-59
You don't add these two sizes together do you?   The office I am now working in has always done it that way.  Maybe that is right but I thought that you billed these seperate just like the 11400's and 11601's   

I thought the only time you added anything together was the repair closure in the 12000's and the 13000's if the same anatomic site and same degree of closure.

Thank you so much for the help,   km


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## mitchellde (Aug 27, 2009)

Yes you are right each advancement flap covers a different defect and the codes must reflect that, and you do not code the excision when you do a flap repair.  The repair codes yes you add the lengths as you stated.


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## msmurdaugh (Aug 28, 2009)

Thanks Guys. I am new to coding for Dermatology also and this was a big help. I will continuue to watch for neat little tips.


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