Dermatology Coding Alert

Question: A dermatologist excises three benign lesions on a patient's right arm, each with a 1-cm diameter. The dermatologist removes an extra 0.3-cm margin surrounding each lesion. Each excised lesion also required an intermediate closure. How should I code this?


Minnesota Subscriber


Answer: Before jumping to 11401 (Excision, benign lesion including margins, except skin tag ...; excised diameter 0.6 to 1.0 cm), remember to include the margin of excised skin around the lesion when you calculate the total diameter of the excised lesion.

In this case, you would add the 0.3-cm margins to the 1.0-cm lesion, making the total excision diameter 1.6 cm per lesion. This would correctly warrant 11402 (... excised diameter 1.1 to 2.0 cm). Make sure to report 11402 three times because there were three lesion removals.

But don't stop there. If each excised lesion required an intermediate closure, you should add the length of the three repairs and report another whole code for the repair.

Here's how: Add the diameters (1.6 + 1.6 + 1.6 = 4.8) and report the appropriate intermediate repair code. You would report 12032 (Layer closure of wounds of scalp, axillae, trunk and/or extremities; 2.6 cm to 7.5 cm) in addition to the lesion excision codes.