Advanced Search

Primary Care Coding Alert

You Be the Coder :

Does a Single Cut Lead to Excision Exception?

Published on Sat Jun 06, 2009

Question: An FP performs a level-two E/M on a new patient, during which she discovers a pair of lesions on the patients right hand. One of the lesions was 0.5 cm, and the other was 0.3 cm; the injuries were 1.0 cm apart. Using a scalpel, the NPP removes both lesions with one excision. Should I report one or two excision codes for this procedure? Indiana Subscriber Answer: Since the NPP performed both excisions with a single incision, you should group the excisions together and report one code for both. Because the provider excised multiple lesions with the same excision, you should add the lengths of the two excisions to the margin between the lesions, and choose a code based on that length. (In your scenario, 0.5 + 0.3 + 1.0 = 1.8 cm.) On the claim, report the following: " 11422 (Excision, benign lesion including margins, except skin tag [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Primary Care Coding Alert

View All