# Destruction and Shave Removals***HELP pls!



## fallondderm@hotmail.com (Apr 17, 2012)

Someone please help me.... 
Our office has been open almost 3 ys now and my dr has been coding her ED&C and shave removals by adding the sizes if multiple were done at same TOS. 

Is that correct??

My understanding is when multiple's are done on same site and same day you would code say a 17262, 17262-76, 17262-76

Same for a shave removal...repeat the code w a 76 is it was the same site are and same day. 

Can anyone elaborate pls???

Thank You!


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## fallondderm@hotmail.com (Apr 17, 2012)

Can anyone pls tell me....dr is frusterated and is doubting the rules. She is adding the size of ALL to create her code....


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## mitchellde (Apr 17, 2012)

I am not sure what you mean by adding the size.  But if you mean she codes one removal code based on the combined size of all lesions that is incorrect.  But you need the 59 modifier and not the 76.  When multiples are performed each successive removal is not a repeated service it is a distinct and separate service since it was a different site.  Assuming the code can be billed separately.  I do not have access to my book.  The 76 modifier is for use when the exact same procedure is repeated in a different session.


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## cherramos (Apr 24, 2012)

It sounds like your doctor has confused repairs with removals.  Repairs, when warranted, are coded according to the sum of their lengths per anatomic site. 

And Debbie Mitchell is right, you want to use that 59 instead of 76. 

Wow, just noticed the date you posted - I am no help by now


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## fallondderm@hotmail.com (Apr 30, 2012)

Thank you both! I checked w Inga Ellzey to get some back up to show her. But she does say use a 76 instead of the 59. But in the case it was the same procedure on same are on same day. So I warranted the 76 and the claim did get pd correctly. Thanks though. I am doing a shave removal now and she did 3 but I dont know if i should use a mod or not. Inga Ellzey says no mod but I think I should use a mod.....any advice?


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## mitchellde (Apr 30, 2012)

be careful using the 76, it must clearly be a different session to use it.  The reason you want to be careful is it will bypass discounting and when two or more procedures are performed in the same session you use the 59 and the second and subsequent procedure will be discounted as they are suppose to.
if she performed 3 separate shavings and the code is not a multiple then you may list it 3 times using the 59 modifier if the code is a multiple as in saying lesion(s), then you cannot bill more than one code.

I am not sure who Inga Elizey is but to always use the 76 for a second procedure of the same code is incorrect.


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## Susan (May 3, 2012)

mitchellde said:


> be careful using the 76, it must clearly be a different session to use it.  The reason you want to be careful is it will bypass discounting and when two or more procedures are performed in the same session you use the 59 and the second and subsequent procedure will be discounted as they are suppose to.
> if she performed 3 separate shavings and the code is not a multiple then you may list it 3 times using the 59 modifier if the code is a multiple as in saying lesion(s), then you cannot bill more than one code.
> 
> I am not sure who Inga Elizey is but to always use the 76 for a second procedure of the same code is incorrect.




I just wanted to agree with Debra on this point.  PLEASE be careful in using the 76, this could get your practice in so much trouble.


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