Part B Insider, Vol.8 (Coding Institute)
Just an example and hope it helps and agree w/ Jarts
Although musculoskeletal codes offer increased pay for more complicated, deeper excisions, some exceptions may apply, says Lisa Center, CPC, physician billing certified professional coder with Mt. Carmel Regional Medical Center in Pittsburg, KS.
Example: A patient presents to your practice with a 2-cm lipoma on his forehead that appears to lie under the frontalis muscle.
Take note: If your physician performs a lipoma excision in the flank, you should report 21930 (Excision, tumor, soft tissue of back or flank) because lipomas typically develop in the subcutaneous tissue beneath the skin. Code 21930 will pay you about $420.
This general principle does not apply to lipomas on the face or forehead, however, because in such instances the skin is so close to the bone, Center says.
For the instance above, the only facial musculo-skeletal excision code, other than those involving bone, is 21015 (Radical resection of tumor [e.g., malignant neoplasm], soft tissue of face or scalp). But because the physician did not perform a radical resection, you should not report 21015.
So, you should bill 11442 (Excision, other benign lesion, face ...; excised diameter 1.1 to 2.0 cm) for the lipoma excision on the patient's forehead, which will pay you $170. Although the payment amount is undeniably less, all experts agree that you should only report the code that best describes what your physician documents