Wiki Why cant I bill a D23.72 and D22.72 together?

[ljstoker]

I billed todays options and they stated I could not bill a d22.72 (melanocytic nevus) and a D23.72 (dermatofibroma) together on a E/M code. I do not see why you can not have these two lesions on one leg/encounter. They told me it was for CMS Clinical edit which i thought was for procedure codes? Help anyone.

 

[Jlittle09]

If you will look at the beginning of the D23 section, it says under Excludes1 melanocytic nevi (D22.-) and Excludes1 means "not coded here", it indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 says two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition. So, I don't think it matters what you are coding, E/M or procedure, it's just a general. Hope this helps!