Wiki Injection CPT 11900/11901?

[arozance27]

Hoping for some clarification.

Provider performs Kenalog injection for lichen planopilaris. These are not lesions as the CPT is defined. Should a different CPT be used for the administration.

Per provider, ” I injected nearly the entire frontal and temporal scalp using a grid pattern with over twenty injection sites. Do I count this entire region as one lesion?"

Thanks for your input!

 

[SharonCollachi]

Lichen planopilaris would start out as many separate lesions, that can spread and join. I would count what he did as 11901. There is the "spirit of the law" and there is the "letter of the law". I would certainly call this the spirit of the law. If the patient had come in when there were twenty separate lesions, the work would have been exactly the same as when he came in with those separate lesions joined together. Photographs in the medical record would be important.

 

[thomas7331]

I would agree. 'Lesion' is a generic term for an area of skin affected by a disease - I don't think it's a requirement for a provider to use that specific term in order to use these codes. Since the intent of the injections is to treat specific areas of the affected skin, 11901 would be the most appropriate code in this situation.