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#1
12-11-2009, 10:04 AM
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14060
benign lesion removed from left upper eyelid
a bilobar rotational flap from the nasal bridge was fashioned with a 15 blade and westcott scissors and this was rotated to fill the medial half of the defect. The flap was elevated and placed into position. Anchoring sutures were made to the deep soft tissue for placement for the lateral half of the wound. A 1cm wide advancement flap was fashioned horizontally in the eyelid. Incision was made w/ a 15 blade and the flap was elevated w/ wescott scissors.The flap was advanced medially. Anchoring sutures were placed. Dr charged 14060/LT and 14060/51LT. Shouldn't 11640/E1 be billed also for the removal of the lesion?
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Ann Marie CPC New Britain, CT 
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#2
12-11-2009, 03:46 PM
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CPT guidelines
First read your CPT guidelines which clearly state that excision of the lesion should NOT be separately reported with adjacent tissue rearrangement.
Additionally ... CPT guidelines direct you to the the 679xx section when this involves a full thickness repair of the eyelid. (I can't really tell from this note whether this is the case.) F Tessa Bartels, CPC, CEMC
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