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Dermatology Coding Alert

NCCI 10.2 Update:

Don't Report J2001 With 223 Dermatology Codes

Published on Thu Jul 01, 2004

Learn these new designations or you'll risk losing out on deserved pay

The National Correct Coding Initiative edits, version 10.2, declare several dermatology codes non-mutually exclusive from the injection of lidocaine for intravenous infusion (J2001). These new codes will affect your reporting from July 1 through Sept. 30.

Reality: This means that you cannot report these codes together.

The following is a list of only a few of the 223 new non-mutually exclusive codes for J2001 (Injection, lidocaine HCl for intravenous infusion, 10 mg):

  • 10120 - Incision and removal of foreign body, subcutaneous tissues; simple
  • 11000 - Debridement of extensive eczematous or infected skin; up to 10% of body surface
  • 11300 - Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.5 cm or less
  • 11401 - Excision, benign lesion including margins, except skin tag [unless listed elsewhere], trunk, arms or legs; excised diameter 0.6 to 1.0 cm
  • 11730 - Avulsion of nail plate, partial or complete, simple; single.

    Prior to these edits, you were never allowed to report local anesthesia codes with any of these integumentary codes, says Pamela J. Biffle, CPC, CCS-P, president of PB Healthcare Consulting and Education in Fort Worth, Texas. Now, with these most recent edits, "there is documentation to support it," she says.

    For instance, if the dermatologist anesthetizes an area on the patient's arm (J2001) with an injection of lidocaine before he debrides a section of eczematous skin that measures less than 10 percent of the body's total surface area (11000), you would not separately bill for the injection.

    Note: Go to www.cms.hhs.gov/physicians/cciedits/default.asp for links to documents that explain the edits, including the NCCI Policy Manual for Part B Medicare Carriers, the Medicare Carriers Manual, and an NCCI Question-and-Answer page.

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