Internal Medicine Coding Alert
Cyst Removal
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? You need to attach modifier -59 to 11404 to show the insurer that the second excision was separate and distinct from the first procedure.
Texas Subscriber
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 internist's removal of the 3.3-cm cyst.
Both 11406 and 11404 are appropriate for three reasons:
Internal Medicine Coding Alert
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