Dermatology Coding Alert

Question: Can I append modifier -57 on a consult when the physician decides to perform a lesion excision (11602 and 12032) on the same day?

Virginia Subscriber

Answer: You should not append modifier -57 (Decision for surgery) to your consult code because you should use modifier -57 for major procedures only. Instead, you can append modifier -25 (Significant, separately identifiable E/M service by the same physician on the same day of the procedure or other service) to the E/M consult code in addition to reporting 11602 (Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 1.1 to 2.0 cm) and 12032 (Layer closure of wounds of scalp, axillae, trunk and/or extremities [excluding hands and feet]; 2.6 cm to 7.5 cm).