Wiki Denial of Excision w/ Intermediate repair

[kana_gurl]

Hello,

I am receiving a denial for coding combo:

11602
12032

I understand that simple repair is included in excision, but the doctor noted an intermediate repair. What modifier am I missing here? Insurance says that the excision is included in the intermediate repair.

Thank you in advance!

 

[dclark7]

Check your codes, you billed a lesion with an excised diameter of 1.1 to 2.0 cm but your repair code is 2.6 cm to 7.5 cm. Read the measuring instructions that are shown prior to the excision codes in your CPT book, this will help you understand how the docotr measures the lesion.

 

[kana_gurl]

thanks

Dclark7,

Thank you, will do. The doctor actually picked the codes so I will need to go over that with the Dr as well.