Wiki Excision 11623 denied with pedicle flap 15736

[abaer01]

Can someone please assist with this? I'm having trouble finding info on whether the excision of a malignant lesion 11623 is included in the pedicle flap code 15736. I don't see any CPT or NCCI issues, but Aetna denied 11623 as included. The lesion was excised from the finger and pedicle flap taken from the wrist.

 

[fwnewbie]

Do you have site modifiers to show the location of the excision vs flap?

 

[abaer01]

No, but they would be F8 and RT respectively. You think just an anatomical modifier on the excision would do the trick?

 

[fwnewbie]

Well, according to the CPT instructions in order to be paid for both procedures they have to be from separate body areas so site modifiers make sense to me.

 

[abaer01]

Going to resubmit with correct modifiers. Thank you!!!