# eye skin tag/eye skin lesion



## DIVINE50 (Feb 10, 2016)

Can anyone review this and tell me what codes you get? The physician wants to use 11200 for procedure 1 and 11440 for procedure 2.   The path report shows fibroepithelial polyp for both of these procedures. I would just  like to see what others get for these. 


PREOP DIAGNOSIS:1. lesion on left upper lid lateral- skin tag 
2. left eyelid margin lesion mid lid 
POSTOP DIAGNOSIS: 1.lesion on left upper lid lateral- skin tag
2. left eyelid edge lesion mid lid
PROCEDURE:1. Removal of skin tag left upper lid 
2. excisional biopsy of left  upper lid edge lesion with closure. 
ANESTHESIA: Injection with 1%Xylocaine 1:100,000 epinephrine
INdications; Presen greater than 6 months, 2 Separate lesions, left upper lid skin tag which was prominent and irritative to pt causing discomfort on opening and closing of the lid.  Pt desired to have it removed. Additionally pt has noticed a lesion on the left eye upper lid edge that has increased over several months bothersome to pt, some times in the sitting position it tends prolapse over the edge. It is elevated, lobulated, skin colored. It is not on a pedicle.s
DESCRIPTION OF PROCEDURE: Pt was brought to the procedure room, laid in a semi lounge chair position and prepped and draped in the usual manner.  Once good local anesthesia was applied. the upper lid skin tag was in the lateral aspect of the lid , midway between the brow and lid edge.  Pt additionally has blepharochalasia. The skin tag was lifted and trimmed at its base, a small prominence still persisted thus the castroviejo scissors were used to trim it.  The loose skin tended to drape together easily without tension. Dermabond was applied with a fine probe dipped in Dermabond and applied

Next the eyelid margin lesion was addressed.  The gross lesion was measured, markings around it were made.  A knife was used to excise the gross lesion of the lid margin lesion which approximated the lid edge within a 1-2 mm. The lesion was skin color ,elevated and lobulated. And tended to hang over the  margin in a sitting position. .The lesion was excised using the knife blade 11 and a castroviejo scissors.
it was a 2x3 mm lesion. The skin edges were approximated and dermabond was carefully applied with a small probe instrument .
Findings : lesion skin tag upper lid away from margin edge
upper eyelid edge (mid)lesion lobulated, elevated 2x3 excised and reapproximated


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## tdesher (Mar 15, 2018)

*Answer?*

I am having a similar issue, did you ever receive a response about this? Here are my reports, they are saying to bill them as 67840 but I think it should be 11200 because it says skin tag

PREOPERATIVE DIAGNOSIS: Skin tag involving the left upper eyelid. 
POSTOPERATIVE DIAGNOSIS: Skin tag involving the left upper eyelid. 
PROCEDURE PERFORMED: Excision of pedunculated skin tag involving the left upper eyelid. ANESTHESIA: Local infiltration with 1% lidocaine with epinephrine. 
SPECIMENS: Specimen x1. 

PREOPERATIVE DIAGNOSES:  Skin tags x2 involving the left upper eyelid, one pigmented sessile skin lesion involving the left lateral canthal area.
POSTOPERATIVE DIAGNOSES:  Skin tags x2 involving the left upper eyelid, one pigmented sessile skin lesion involving the left lateral canthal area.
PROCEDURES PERFORMED: Excision of skin tags x2 involving the left upper eyelid and excision of a pigmented sessile lesion involving the left lateral canthal area.
ANESTHESIA:  Local infiltration with 1% lidocaine with epinephrine.
SPECIMENS:  Specimen x3.


PREOPERATIVE DIAGNOSES:  Skin tags x2 involving the left upper eyelid, one pigmented sessile skin lesion involving the left lateral canthal area.
POSTOPERATIVE DIAGNOSES:  Skin tags x2 involving the left upper eyelid, one pigmented sessile skin lesion involving the left lateral canthal area.
PROCEDURES PERFORMED: Excision of skin tags x2 involving the left upper eyelid and excision of a pigmented sessile lesion involving the left lateral canthal area.
ANESTHESIA:  Local infiltration with 1% lidocaine with epinephrine.
SPECIMENS:  Specimen x3.


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## pclaybaugh (Mar 20, 2018)

I am researching this as well and found the following article:

https://www.reviewofophthalmology.com/article/how-to-document-and-code-lesion-removal

CPT manual contains instructions at the beginning of the section for Excisions / Destructions just above CPT 67800. It states: “Codes for removal of lesions include more than skin (ie., involving lid margin, tarsus, and/or palpebral conjunctiva.” The procedure note describing the surgery should describe removal of more than just skin to support the use of this code.


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## prayercoder (Mar 28, 2018)

*Skin tags*

Your doctor is using 11200 for the skin tags which are the same thing as fibroepithelial polyp. He is using 11440 on the second LESION because he is not considering it a skin tag because it doesn't have a pedicle.


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