Dermatology Coding Alert

The answer to a reader's question in the September 2005 Dermatology Coding Alert ("Append 59 to Indicate 2 Surgical Sites") was incorrect. For a scenario in which a dermatologist had removed two benign lesions--one from the shoulder and one from the abdomen--as well as an actinic keratosis from the patient's face, we suggested these codes:

Line 1: 11400
Line 2: 11400-59
Line 3: 17000-59.

Problem: The National Correct Coding Initiative bundles 11400 (Excision, benign lesion including margins, except skin tag [unless listed elsewhere], trunk, arms or legs; excised diameter 0.5 cm or less) and 17000 (Destruction, all benign or premalignant lesions other than skin tags or cutaneous vascular proliferative lesions; first lesion). However, 17000 is the Column 1 code in this bundle, and modifier 59 (Distinct procedural service) should always appear next to the Column 2 code--11400 in this case. And, your carrier may require modifier 76 (Repeat procedure by same physician) appended to the second line of 11400.

The correct coding for the above scenario is:

Line 1: 17000
Line 2: 11400-59
Line 3: 11400-59-76.

We apologize for the error.