Wiki Excision of multiple lesions

[cpccoder2008]

Ok, here is an example. A patient comes in with multiple lesions on the leg and back. Two lesions from the back are removed first, one is 1.0 cm and the other is 2.0 cm, the wound is closed with two layers. Two additional lesions are removed from the legs, one is 1.0 and the other is 2.0, the wound is closed with two layers. Here is what i come up with 11401, 11402, 11401, 11402, and 12032. I was told to code all the repairs seperately but according to the CPT guidelines you are to add them. Can someone please clarify as to how they are coding this and why ?

 

[mitchellde]

you code each lesion separate and use the 59 modifier to separate them and code only one repair code of the same type in the same region. so you have a total of 4 lesions and 1 repair
11402
11402 59
11401 59
11401 59
12032 (might need a 59 on this as well check the edits)

 

[cpccoder2008]

That's what i thought but someone told me that you don't code that way for the facility side. I worked for the physician's side and thought that's how we were doing it but when i spoke with the coder there she said no she codes each repair on it's on to show it has been done, i explained to her that by doing this they would pay the wrong one and you'd be missing out on money but she said she was told to do it this way and the hospital coder agrees.

 

[mitchellde]

I am sorry to disagree with them but I code for the facility inpatient and outpatient as well as the provider and all are done the same way. It has been this way since the early 80s so it is not a new ruling and there is not a new ruling that overides this. So I will have to disagree with them.