Dermatology Coding Alert
Consider Cleaning and Removal for Repair Codes
PDF
Question: How should I report repair of an irregular, 3.5-cm laceration of the chin involving subcutaneous tissue and muscle?
Mississippi Subscriber
Answer: The repair meets the requirements for an intermediate closure in several ways. Therefore, you should consider 12052 (Layer closure of wounds of face, ears, eyelids, nose, lips, and/or mucous membranes; 2.6 cm to 5.0 cm).
An intermediate repair involves layered closure of one or more of the deeper layers of subcutaneous tissue and superficial (non-muscle) fascia, in addition to the skin closure, according to CPT.
CPT also states that extensive cleaning and removal of debris for even single-layer closures constitutes intermediate repair. Also, the additional non-skin layers the dermatologist closed are consistent with an intermediate repair.
In contrast, to consider a closure complex, you need more than just multiple layered closures. To code for a complex repair, look for documentation describing that in addition to layered closure, the dermatologist corrected a defect or performed extensive debridement of tissue.
Dermatology Coding Alert
- Don't Underestimate Justifying Medical Necessity for Benign Lesion Excisions
Provide more than one reason code, or you may face denials If your dermatologist performs [...] - Follow These 5 Tips for Top-Notch Reporting Procedures
Simply checking for coding accuracy can streamline your practice As challenging as it may be [...] - Refer to This Chart for Corresponding Medical-Necessity Codes Of Benign Lesions
Include Category III codes and watch the Medicare denials diminish To make sure you\'ve proven [...] - You Be the Coder:
Consider Cleaning and Removal for Repair Codes
Question: How should I report repair of an irregular, 3.5-cm laceration of the chin involving [...] - Consults Vs. Referrals:
Coding Experts Unlock the Secrets
Your dermatologist\'s opinion should come with a price Whenever your dermatologist performs a consult, make [...] - Consider Modifier -25 for Consult With Same-Day Treatment
Dermatologists often face denials when they perform a consult and provide treatment on the same [...] - Reader Questions:
Let Time Guide Your Follow-Up E/M Coding
Question: A patient saw the dermatologist to get results on her biopsies and monitoring. The [...] - Reader Questions:
Consider Initial/Subsequent for 15000
Question: A patient came to our dermatology practice with ulcers of plantar and hallux surfaces [...] - Reader Questions:
Overlook Time Limits With Consults
Question: If my dermatologist performs an office consultation on a patient, how much time must [...] - Reader Questions:
Modifier -59 Comes in Handy for Multiple Excisions
Question: The dermatologist excised two sebaceous cysts from the patient\'s back. One cyst measured 4.7 [...]