Internal Medicine Coding Alert
Modifier 59 Helps You Report 2 Excision Codes
Question: The internist excised two sebaceous cysts off of the patient's back. One cyst was 4.7 cm, and the other was 3.3 cm. How should I code this? Answer: For the 4.7-cm cyst excision, you should assign 11406 (Excision, benign lesion including margins, except skin tag [unless listed elsewhere], trunk, arms or legs; excised diameter over 4.0 cm). You should report 11404-59 (... excised diameter 3.1. to 4.0 cm; distinct procedural service) for your surgeon's removal of the 3.3-cm cyst. Answers for You Be the Coder and Reader Questions were provided by Kathy Pride, CPC, CCS-P, a coding consultant for QuadraMed in Port St. Lucie, Fla.; Bruce Rappoport, MD, CPC, a board-certified internist who works with physicians on compliance, documentation, coding and quality issues for Rachlin, Cohen & Holtz LLP, a Fort Lauderdale, Fla.-based accounting firm with healthcare expertise; and Tara Conklin, CPC, an independent coding consultant in Wesley Chapel, Fla.
Rhode Island Subscriber
Reporting 11406 and 11404 is correct for three reasons:
1. the lesions were benign
2. they were located on the patient's "trunk"
3. the cysts' measurements match the specified lesion diameters in the codes' descriptors. You need to attach modifier 59 (Distinct procedural service) to 11404 to show the insurer that the second excision was separate and distinct from the first procedure.
Internal Medicine Coding Alert
- ICD-9 2006 Expands Your CKD Coding Options
Tip: Use a patient's disease stage to pick the right code
If your internist manages or [...] - Don't Lose Sleep Trying to Fathom New Sleep-Problem Codes
CMS creates 21 new ICD-9 codes that you'll need to learn by Oct. 1
CMS' new [...] - You Be The Coder:
Prescription Refills
Question: We often refill patients' prescriptions but don't know how to charge the insurance carriers [...] - 2 Top Tips Explain How to Use ABNs to Get Fair Payment
Find out why a patient's refusal to sign doesn't mean you won't get paid
Don't write [...] - Use This Handy Chart to Update Your Current Sleep-Disorder Diagnoses
Match the current codes with the ones you'll be using in a few months
You can [...] - READER QUESTIONS:
You Have to Carve Out G0101 and Q0091, Too
Question: Your article "How to Carve Out Your Reimbursement for Traditional Preventive Visits" in the [...] - READER QUESTIONS:
Get the Lowdown on Tricky New BMI Codes
Question: CMS has added 18 new V codes to test for body mass index in [...] - READER QUESTIONS:
Use Modifier 24 to Keep Behaviors Straight
Question: The internist excised an "uncertain behavior" neoplasm from a patient's skin. Five days later, [...] - READER QUESTIONS:
Own the Stress-Test Machine? Then Use 93015
Question: How should I code an in-office pharmacological stress test, including the adenosine and the [...] - READER QUESTIONS:
Limit Your Follow-Up Consult Charges
Question: If the internist wants to follow up with a patient once a month after [...] - READER QUESTIONS:
Modifier 59 Helps You Report 2 Excision Codes
Question: The internist excised two sebaceous cysts off of the patient's back. One cyst was [...] - Patient Registration Secrets to Save You Thousands
Presented by Steven M. Verno, CMBSI
The following supplement to Internal Medicine Coding Alert is the [...]
