Wiki Multiple Lipoma Excisions

[MAMILLER]

Pt had a total of 6 deep lipomas removed from back area. All 6 had separate incisions. One lipoma 21931 due to size and depth the other 5 are 21930. How do I code for the 5? Do I put 21930 on five separate lines? Or am I only able to bill it one time?
Advise and guidance appreciated.
Mary
CPC, Springfield, OR

 

[Orthocoderpgu]

You can do it either way. I personally I would separate them all on individual lines. It makes it easier working the back end of claims.

 

[dkissel]

For multiple units, you should check the MUE (Medically Unlikely Edits) table at CMS.gov as a starting point. Depending on payer, you may want to submit max allowed units on one line, then other units on another line with modifer 59. Perhaps that payer needs you to go another route altogether. However, for 21930, I believe the MUE is 5 so most payers would accept 5 units on one line.

 

[MAMILLER]

THANKS so much for your prompt replies and advise. I really appreciate it.