ED Coding and Reimbursement Alert

Question: A patient presents to the ED with a lesion on his forehead and one on his neck; he says the lesions "itch really bad." The patient is bleeding due to his scratching of the wounds. The physician performs an expanded problem focused history and physical exam. The patient has no access to a dermatologist, so the physician decides to excise the lesions herself. The physician performs a 1.6 cm lesion excision on the patient's forehead wound and a 1.8 cm lesion excision on the patient's neck wound. (The tissues are both benign.) The physician then writes prescriptions for antibiotics and Tylenol No.3 and discharges the patient. Do I need a modifier for the lesion repair codes? Utah SubscriberAnswer:Maybe. Since the repairs occurred in two separate anatomical areas, most insurers will accept the repair codes without any modifiers. For this encounter, you'll typically report the following:11442 (Excision, other benign lesion [...]