ED Coding and Reimbursement Alert

Question: When CPT^® code 99284 is billed with CPT^® code 11643 for the same date of service is there separate reimbursement?

Florida Subscriber

Answer: You should be paid for both the 99284 and the 11643 (Excision malignant lesion…excised diameter 2.1 to 3.0 cm) if chart documentation supports both services. There is no CCI edit bundling those two services. You should use the 25 modifier on the E/M service to show it was separately identifiable.

Code 11643 would not be typically reported in the ED setting.