General Surgery Coding Alert
Check Report Before Selecting Benign or Malignant
Question: When coding removal of a skin lesion, how do I know if I should select the benign or malignant code? Texas Subscriber Answer: You should never "guess" whether a skin lesion the surgeon has removed is malignant or benign. Rather, you should wait for the pathology report to return before selecting the appropriate code. The surgeon sends the removed lesion to pathology for a determination. Pathology reports that the lesion is benign. You should select CPT code 11406.
For example, the surgeon removes a 4.5-cm lesion (including margins) from the patient's left shoulder. Depending on the status of the lesion (benign or malignant), the possible code choices include either 11406 (Excision, benign lesion including margins, except skin tag [unless listed elsewhere], trunk, arms or legs; excised diameter over 4.0 cm) or 11606 (Excision, malignant lesion including margins, trunk, arms or legs; excised diameter over 4.0 cm).
General Surgery Coding Alert
- New Diagnoses for Decubitus Ulcers Should Help Reduce Denials
Site-specific ICD-9 codes will increase your options when describing multiple ulcers General surgery coders, take [...] - You Be the Coder:
Do Consults Have Time Limits?
Question: If I perform an office consultation on a patient, how much time must elapse [...] - Biopsy and Excision at the Same Time? Think Again
Reserve 11100/11101 for pathology specimens only If you're reporting biopsy codes 11100 and 11101 separately [...] - Are You Reporting Reduced Services Correctly?
Knowing why the physician halted the procedure matters for modifiers -52/-53 When a surgeon provides [...] - If You're Cutting Fees for -52 And -53, You're Losing Out
If you're appending modifier -52 or -53 to a claim, you want to tell the [...] - Our Experts Respond:
What Makes a Postoperative Complication 'Unrelated'?
When deciding whether you should separately report postoperative wound care during the global period of [...] - Reader Question:
Selecting 99291 Means Better Reimbursement
Question: Are there any advantages to choosing critical care codes rather than high-paying E/M codes? [...] - Reader Question:
No More Starred Procedures Means More Modifiers
Question: What's the practical significance of losing the "starred designation" in CPT 2004? For example, [...] - Reader Question:
Check Report Before Selecting Benign or Malignant
Question: When coding removal of a skin lesion, how do I know if I should [...] - Reader Question:
Documentation Should Guide Modifier -22 Use
Question: Our surgeon performed a laparoscopic cholecystectomy with an attempted intraoperative cholan-giogram. The cholangiogram failed, [...]
