Question: Our dermatologist completed two excisions: one on the patient's shoulder and the other on the patient's abdomen. He also excised an actinic keratosis on the patient's face. When I looked in the National Correct Coding Initiative (NCCI) edits, I saw that NCCI designates codes 11400 and 17000 as mutually exclusive. Does this mean that I cannot bill 17000 and only bill 11400 x 2? Answer: You should report the following codes for the above scenario: You can report the two-excision procedure separately because the dermatologist performed two separate excisions on two separate sites and a separate destruction.
Nebraska Subscriber
By attaching modifier 59, you are notifying the payer that although the NCCI edits bundle these procedures, the dermatologist performed two distinctly separate procedures: excisions and destruction.