Primary Care Coding Alert

Question: The physician removed six papillomas from a patient and administered three different site Xylocaine injections to numb the various areas. Can I bill for these injections in addition to the papilloma removals, or are they bundled?

Nevada Subscriber

Answer: The Xylocaine injection is considered local anesthesia and is therefore bundled with the excision code. Surgical procedures include local infiltration, metacarpal/metatarsal/digital block and topical anesthesia. You should only report the code for the papilloma removal.

To report the removal of the papillomas, you should use the codes for excision of benign skin lesion, in the 11400-11446 series. Select the correct excision code based on the size and location of the lesions. If several, or all, of the lesions were of the same size and removed from the same location, bill the appropriate code x the number of lesions. For example, if the physician removed six benign lesions, all less than 0.5 cm, from the patient's arm, you would report 11400 (Excision, benign lesion, except skin tag [unless listed elsewhere], trunk, arms, legs; lesion diameter 0.5 cm or less) x 6.