# Integumentary Coding Question



## Skinne (Jun 1, 2007)

I am not sure if I have interpreted this correctly.  In the Integumentary section of the CPT book under excision of benign or malignant lesions (page 53 or 54 of the 2007 book), it says that if a closure requires an intermediate or complex closure, you need to report the excision in addition to the appropriate intermediate or complex closure codes. Does that mean that the intermediate or complex closure code is coded first and the excision is coded second? Also, what modifier would you use on the second code, a -51 or a -59?

I'd appreciate anyone's thoughts on this.  Thanks in advance.

Sheryl Kinne, CPC


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## Donna SanGiovanni (Jun 6, 2007)

first code the closure, then lesionwith -51.


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## Susan (Jun 6, 2007)

*Closures with Lesion Removal*

When coding a intermediate or complex closure with a lesion removal, you would code the Closure first as it has a higher RVU then the actual lesion removal code.  You would place a modifier 51 on the lesion code and expect the appropriate reimbursement as such.  Hope this helps.  I code these everyday.


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## Candice_Fenildo (Jun 7, 2007)

coding a intermediate or complex closure with a lesion removal I code the closure then the lesion removal, My MD's do these on a daily basis as well. 
they were a little confusing as first, but once you get a few dozen under your belt you'll be good to go.


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