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Podiatry Coding & Billing Alert

You Be the Coder :

Shave Errors By Pinning Down Lesion Size

Published on Sat Nov 21, 2009

Question: A patient came for a follow up visit after treatment for an injured ankle. During the examination, our podiatrist found a lesion on the sole of the patient's  oot. The doctor decided to shave the lesion. I billed 11301 for the procedure with 99213, but Medicare denied the claims. What could I have done wrong? California Subscriber Answer: You used the wrong code. Code 11301 (Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.6 to 1.0 cm) does not cover the feet. To bill correctly, you have to use a code from the 11305-11308 series. Depending on the size of the lesion, you'll report one of the following codes: • 11305 -- Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.5cm or less; • 11306 -- ... lesion diameter 0.6 to 1.0cm; • 11307 -- ... lesion diameter 1.1 [...]
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