sfbug23
Contributor
Question I have a provider who did an excision and ED&C on the same site. I wanted to double-check that we can not bill for both procedures but what procedure do you bill for then?
Shave Removal (Malignant): Left Anterior Lower Leg - Central · Preoperative Dimension(s): 1.3
x 1.8 cm (2.34 cm²) · Indications: There is a clinical uncertainty as to the likely diagnosis, particularly
where malignancy (cancer) is a realistic consideration based on the appearance · Postoperative
Dimension(s): 1.3 x 1.8 cm (2.34 cm²) · Surgical Scrub: Alcohol · Anesthesia: 1. lidocaine 1 %-
epinephrine 1:100,000 injection solution (0.5 ml) · Biopsy Technique: tangential (shave) · Procedure
description: Area was cleaned with alcohol and anesthetized. Skin cancer was removed with a blade to
the dermis. After removal curettage and desiccation was performed to the base. White petrolatum and
bandage were applied. Wound care instructions reviewed verbally and patient was instructed to call the
office with any concerns. · Curettage and desiccation of the base was done.
◦ Destruction (Malignant Lesions): Left Anterior Lower Leg - Central · Preoperative
Dimension(s): 1.3 x 1.8 cm (2.34 cm²) · Indications: Malignant Lesion · Surgical Scrub: Alcohol ·
Anesthesia: 1. lidocaine 1 %-epinephrine 1:100,000 injection solution · Hemostasis: Electrocautery -
Electrofulguration · Procedure description: The affected area was cleansed with alcohol and injected
with a local anesthesia. The perilesional skin was curetted in various directions using a dermal curette
and then subsequently electrodesiccation was performed. The wound was cleansed, and then dressed
with antibiotic ointment, telfa, and a pressure bandage. Oral and written postoperative instructions
were also provided.
Shave Removal (Malignant): Left Anterior Lower Leg - Central · Preoperative Dimension(s): 1.3
x 1.8 cm (2.34 cm²) · Indications: There is a clinical uncertainty as to the likely diagnosis, particularly
where malignancy (cancer) is a realistic consideration based on the appearance · Postoperative
Dimension(s): 1.3 x 1.8 cm (2.34 cm²) · Surgical Scrub: Alcohol · Anesthesia: 1. lidocaine 1 %-
epinephrine 1:100,000 injection solution (0.5 ml) · Biopsy Technique: tangential (shave) · Procedure
description: Area was cleaned with alcohol and anesthetized. Skin cancer was removed with a blade to
the dermis. After removal curettage and desiccation was performed to the base. White petrolatum and
bandage were applied. Wound care instructions reviewed verbally and patient was instructed to call the
office with any concerns. · Curettage and desiccation of the base was done.
◦ Destruction (Malignant Lesions): Left Anterior Lower Leg - Central · Preoperative
Dimension(s): 1.3 x 1.8 cm (2.34 cm²) · Indications: Malignant Lesion · Surgical Scrub: Alcohol ·
Anesthesia: 1. lidocaine 1 %-epinephrine 1:100,000 injection solution · Hemostasis: Electrocautery -
Electrofulguration · Procedure description: The affected area was cleansed with alcohol and injected
with a local anesthesia. The perilesional skin was curetted in various directions using a dermal curette
and then subsequently electrodesiccation was performed. The wound was cleansed, and then dressed
with antibiotic ointment, telfa, and a pressure bandage. Oral and written postoperative instructions
were also provided.
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