General Surgery Coding Alert

Question: Following a melanoma excision, our surgeon performed a layered closure. I've heard that we should add the dimensions of the lesion excision to determine the code choice for the closure -- is this correct?New Mexico SubscriberAnswer: No, you should not base the closure code on the lesion excision size at all. Instead, you should base it on the closure size. When the surgeon excises a lesion, the code includes simple (single layer) closure. But if the surgeon performs a layered closure as you described, you can separately bill the intermediate closure.Do this: What you need to know to bill the closure is the longest dimension of the wound. This is likely to be quite a bit longer than the excision itself, because surgeons often create an elliptical excision, which is easier to close. You will identify the total length of the repair and choose the intermediate repair code that matches [...]