ED Coding and Reimbursement Alert

Question: Our physician saw a patient with lesions on his face and cheek. He excised a 2.6-centimeter benign lesion on the patient's chin and a 3.1-centimeter benign lesion from the patient's cheek. The physician then closed the wounds with a layer closure. How should I report this visit?
      
Georgia Subscriber

Answer: For this encounter, you would report three  codes. For the lesion excisions, report 11443 (Excision, other benign lesion including margins [unless listed elsewhere], face, ears, eyelids, nose, lips, mucous membrane; excised diameter 2.1 cm to 3.0 cm) and 11444 (... excised diameter 3.1 cm to 4.0 cm). Code the layer closure with 12053 (Layer closure of wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm).

Why: Most lesion removals require suture closures, and simple closures are included in the surgical package. However, if the patient's wound requires a layer closure, you can report it separately.

How: Report the layer closures by adding the length of the two closures together and assigning the appropriate repair code.

Exception: If the physician excised lesions in different anatomic areas and both required layer closures, you would report two separate codes for the closures.