Otolaryngology Coding Alert

You Be the Coder:

Same Site, Multiple Keloid Excisions

Published on Tue Sep 23, 2014

Question:The otolaryngologist performed three keloid excisions (sizes 1.2, 1.12, and 0.8) from the patient’s right ear. She closed using the z-plasty technique. Do I code based on the sum of the three benign lesions for the closure? CPT® states that the excision is included.

Florida Subscriber

Answer: It is difficult to answer based on the way you asked your question, since a z-plasty can be a complex repair or an adjacent tissue transfer. If the repair was complex (13151-13152, Repair, complex, eyelids, nose, ears and/or lips …), you can bill and code each lesion excision separately. Put a 59 modifier (Distinct procedural service) on the second and third lesion excision to indicate that they are separate sites. But, if the repair was an adjacent tissue transfer (14060-14061, Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips …), the removal of the lesions is considered to be site preparation and cannot be coded nor billed in addition to the repair.

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You Be the Coder:
Same Site, Multiple Keloid Excisions
Question:The otolaryngologist performed three keloid excisions (sizes 1.2, 1.12, and 0.8) from the patient’s right [...]

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