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Primary Care Coding Alert

READER QUESTIONS :

Shelve Excision Codes When It's Just a Shave

Published on Thu May 21, 2009

Question: A patient with superficial lesions on his right hand reports to the FP for treatment. The FP shaves off a 0.4 cm lesion with a 0.3 cm margin, and a 0.9 cm lesion with a 0.4 cm margin. How can I account for the margins when I code this encounter? Texas Subscriber Answer: You cannot account for the margins. On the claim, report the following: " 11306 (Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.6 cm to 1.0 cm) for the 0.9 cm removal " 11305 (& lesion diameter 0.5 cm or less) for the 0.4 cm removal " modifier 51 (Multiple procedures) appended to 11305 to indicate that the FP performed two separate shaves. Remember: Shaving and excision are two distinct lesion procedures. When the FP shaves superficial lesions, any margins she takes are incidental to the removal; in fact, [...]
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