Primary Care Coding Alert

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, the physician might not need to take margins when performing these procedures. Lesion excision codes such as 11400 (Excision, benign lesion including margins, except skin tag [unless listed elsewhere], trunk, arms or legs; excised diameter 0.5 cm or less), however, allow margins on the total measurement.