Dermatology Coding Alert

Published on Sat Nov 07, 2009 PDF

Try your hand at using modifier 59 (Distinct procedural service). A dermatologist removes two benign lesions from the shoulder and another from the abdomen.

He also excises an actinic keratosis from the patient's face.

How will you report this case?

Answer: Code it as follows:

Line 1 -- 17000-59 ((Destruction [e.g., laser surgery, electrosurgery,cryosurgery,chemosurgery, surgical curettement], premalignant lesions [e.g., actinic keratoses]; first lesion)

Line 2 -- 11400 (Excision, benign lesion including margins, except skin tag [unless listed elsewhere], trunk, arms or legs; excised diameter 0.5 cm or less)

Line 3 -- 11400-59

Rationale: The Correct Coding Initiative (CCI) bundles 11400 and 17000, but it designates 17000 as the Column 1 code. Modifier 59 should always appear next to the Column 2 code.