Dermatology Coding Alert

Question: What are the correct ICD-9 and CPT codes for "excision of mole in scalp" for anesthesia coding? .

Maryland Subscriber

Answer: If your dermatologist performed the excision and is also monitoring the patient during this procedure, you should report 99141 (Sedation with or without analgesia [conscious sedation]; intravenous, intramuscular or inhalation). If the dermatologist uses a local anesthetic (such as Lidocaine), there is no separate anesthesia charge. Carriers consider the anesthesia as an integral part of the excision procedure.

If you report conscious sedation codes, CPT coding guidelines require that 1) the performing physician administers the sedation, and 2) an independent trained observer assists the physician to monitor the patient's level of consciousness and physiological status. If the procedure meets these criteria, then you can separately report the conscious sedation. You can also report the code(s) for the other procedure(s) performed in addition to the conscious sedations code, to completely describe the services the dermatologist renders.

Although these codes monitor anesthesia, most insurance companies, including Medicare, do not recognize this code for additional payment.