Dermatology Coding Alert
Reader Question Add Primary and Secondary Defects Before Reporting
PDF
Question: The dermatologist at my practice performed Mohs surgery on a patient with skin cancer. The dermatologist also chose to create a second defect using the Z-plasty method of adjacent tissue transfer to minimize scarring for the patient. How should I report this? Answer: You report code 17304 (Chemosurgery [Mohs micrographic technique], including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and complete histopathologic preparation including the first routine stain [e.g., hematoxylin and eosin, toluidine blue]; first stage, fresh tissue technique, up to 5 specimens) and 17305-17310 for the microscopic examination of the tissue and the number of stages required for the examination. You code the adjacent tissue repair using the appropriate 14000 series code, depending on the site and size of the lesion. -- Answers to You Be the Coder and Reader Questions were reviewed by Linda Howrey, BS, CCS-P, Howrey and Associates in Princeton, Mass
North Carolina Subscriber
According to CPT 2004, you should add together the sizes of the primary defect resulting from the excision and the secondary defects resulting from the flap design so you choose the appropriate code based on the total size of the sum of the defect.
Dermatology Coding Alert
- 4 Questions Help Recover Scar Revision Pay
Verify medical necessity and avoid \'cosmetic\' denials
When your dermatologist performs scar revisions, you should know [...] - Get 100 Percent Reimbursement for Skin Repairs, Skin Grafts
2 tips to steer clear of add-on code denials
When you report add-on codes for your [...] - You Be The Coder:
Removal of Benign Lesions
Question: Recently, our practice has been getting more denials for the removal of benign skin [...] - Don't Let Misuse of 99241-99275 Reduce Your Reimbursement
4 criteria to help you report consult codes
If reporting your dermatologist\'s consultation services sends you [...] - Justify Additional Biopsies or Excisions
Avoid pitfalls when reporting new or established patient consults
If your dermatologist needed to biopsy a [...] - Reader Question:
ROS Determines 'Type' and 'Extent' of Exams
Question: When a dermatologist lists an organ system and documents past medical/surgical history instead of [...] - Reader Question:
Modifiers Pave the Way to Reimbursement
Question: We have a Medicare patient who had multiple skin tag and lesion removal procedures [...] - Reader Question:
Avoid New Patient Status for Established Patients
Question: Our practice includes eight dermatologists. Often, a new patient will see one doctor and [...] - Reader Question:
Check Local Payers Before Billing With 96567
Question: Would you tell me how to code for photodynamic therapy treatments? Should I bill [...] - Reader Question:
Report Incomplete Excisions
Question: The dermatologist sent in a skin specimen and frozen section for evaluation in the [...] - Reader Question:
Use 69300 for Ear Pinning
Question: How should I report ear pinning?
Nebraska Subscriber
Answer: Ear pinning is also known as otoplasty. [...] - Reader Question Add Primary and Secondary Defects Before Reporting
Question: The dermatologist at my practice performed Mohs surgery on a patient with skin cancer. [...]