Wiki medicare denial for lesion excision

[paula f3]

I have a denial from Medicare "not deemed medically necessary". Physician excised two lesions one on the scalp and the other on the leg smaller than 1 cm, pathology came back as hemangioma of scalp and leg. I coded per pathology report, 228.01.
Looking at the LCD for Az , 228.01 is not a DX for medical necessity. Is there another diagnosis I could have used? Is this a case where we should have had the patient sign an ABN? The problem is we did not know he size of lesion until after the surgery.

Paula

 

[mitchellde]

You can use V71.1 for examination for suspicious malignant neoplasm not found first listed and the 228.01 secondary, this should work with the benign excision codes.