Reader Question:
Pick Your Lesion Code Based on Largest Diameter
Published on Wed Oct 24, 2012
Question: Our physician performed an excision of benign lesion and wants to bill 11420, but I'm not sure if I should bill this code with four units or what. The pathology shows the lesions size as follows:0.2 x 0.2 x 0.1 cm0.5 x 0.5 x 0.4 cm0.7 x 0.6 x 0.3 cm0.5 x 0.2 x 0.2 cmWhat should I report?North Dakota SubscriberAnswer: Per CPT® guidelines you report separately the removal of each discrete lesion. If all of these were excised from the genitalia, you pick the code based on the largest diameter for each. Therefore, you should report 11420 (Excision, benign lesion including margins, except skin tag [unless listed elsewhere], scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less) x 3 and 11421 (...excised diameter 0.6 to 1.0 cm) x 1.
