Dermatology Coding Alert

Published on Sat Jan 01, 2005 PDF

Question: The dermatologist excised two benign lesions of about the same size (roughly 0.8 cm) from the patient's neck. They only required a simple suture. How should I report the two excisions?


Ohio Subscriber

Answer: You should report each lesion the physician excised separately on your claim, according to CPT. In this case, you have two options for reporting this service. First, you can submit 11421 (Excision, benign lesion including margins, except skin tag [unless listed elsewhere], scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm) and 11421-51 (Multiple procedures) to cover the two procedures your dermatologist completed.

Another way: You can use 11421 and place a "2" in the units box of the CMS 1500 claim form.
 
Be sure to ask your payer which way it prefers you to submit this claim, because some carriers do not recognize modifier -51 or have software that automatically adds the modifier to multiple-procedure claims.