Dermatology Coding Alert
2 Sebaceous Cysts
PDF
Question: The dermatologist excised two sebaceous cysts off of the patient's back. One cyst was 4.7 cm and the other was 3.3 cm. How should I code this?
Rhode Island Subscriber
Answer: For the 4.7-cm cyst excision, assign 11406 (Excision, benign lesion including margins, except skin tag [unless listed elsewhere], trunk, arms or legs; excised diameter over 4.0 cm). Report 11404-59 (... excised diameter 3.1. to 4.0 cm; distinct procedural service) for your surgeon's removal of the 3.3-cm cyst. Reporting 11406 and 11404 is correct for three reasons:
1. The lesions were benign.
2. They were located on the patient's "trunk."
3. The cysts' measurements match the specified lesion diameters in the codes' descriptors.
Append modifier 59 (Distinct procedural service) to 11404 to show the insurer that the second excision was separate and distinct from the first procedure.
Dermatology Coding Alert
- CPT Update:
Simplify Your Injection Coding in 2006 With 5 Principles
Lump antibiotics and therapeutic injections into 90772, regardless of payer You can stop denials for [...] - You Be the Coder:
2 Sebaceous Cysts
Question: The dermatologist excised two sebaceous cysts off of the patient's back. One cyst was [...] - Get Up to Speed on Drug Administration Coding for 2006
Clip and save these important infusion crosswalks You can quickly submit drug administration claims using [...] - News You Can Use:
Expect Retroactive Physician Payment Adjustments
When Congress finalizes fee schedule, you won't have to resubmit old claims Dermatologists who've been [...] - Avoid Terminology Traps in Biopsy and Excision Coding
Knowing when to report excisions instead of biopsies can save you $73 When it comes [...] - Reader Questions:
Charge Outpatient Consult for Observation
Question: Another doctor asked my dermatologist for a consult with a patient who had been [...] - Reader Questions:
Look to Lesion Excision for Mole Removal
Question: What is the appropriate code for "removal of mole"? I've searched the entire CPT [...] - Reader Questions:
Extra Cleaning Earns Intermediate Repair
Question: Our dermatologist removed extensive debris from a wound that then required a single-layer closure. [...] - Reader Questions:
Append 51 to Lesser-Valued Procedure
Question: A dermatologist excises a benign skin lesion with an excised diameter over 4.0 cm [...] - Reader Questions:
Written Consult Request Isn't Mandatory
Question: We've heard conflicting information about the requirement for a written request before our dermatologist [...] - Reader Questions:
Multiply for Correct Graft Code
Question: We have a trauma victim who requires a skin graft. The donor site is [...]