Ob-Gyn Coding Alert

Question: Our physician performed an excision of 4 benign lesions 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 cm

0.5 x 0.5 x 0.4 cm

0.7 x 0.6 x 0.3 cm

0.5 x 0.2 x 0.2 cm

What should I report?

North Dakota Subscriber

Answer: 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.