ED Coding and Reimbursement Alert

READER QUESTIONS:

Pay Attention to Area on Shaving Claims

Question: A patient reports to the ED with a dermal lesion. Using a scalpel, the ED physician horizontally slices the lesion off (total excision area was 2.6 cm). Is this an excision or shaving? Arkansas Subscriber Answer: This is a shaving, but you're missing one important component -- body area, as your code choice depends on it. Go back and check the notes to determine where the dermal lesion was. Then choose one of the following: • 11303 -- Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter over 2.0 cm • 11308 -- Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter over 2.0 cm • 11313 -- Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter over 2.0 cm. Explanation: CPT defines excision as "full-thickness ... removal of a lesion." Shaving, however, implies [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

ED Coding and Reimbursement Alert

View All