ED Coding and Reimbursement Alert

Question: A patient reports to the ED with a dermal lesion. Using a scalpel, the ED physician horizontally slices the lesion off (total excision area was 2.6 cm). Is this an excision or shaving?

Arkansas Subscriber

Answer: This is a shaving, but you're missing one important component -- body area, as your code choice depends on it. Go back and check the notes to determine where the dermal lesion was. Then choose one of the following:

• 11303 -- Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter over 2.0 cm

• 11308 -- Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter over 2.0 cm

• 11313 -- Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter over 2.0 cm.

Explanation: CPT defines excision as "full-thickness ... removal of a lesion." Shaving, however, implies superficial lesion removal, which best describes your scenario.