General Surgery Coding Alert

Question: When our surgeon excises multiple lesions, I’ve heard that we should we add the sizes together and bill for one excision. Is that correct? Florida Subscriber Answer: No, that is not correct, although it is a "common misconception," according to CPT® Assistant. Do this: You should separately bill for each lesion using modifier 59 (Distinct procedural service) or perhaps multiple units of service, depending on payer instruction. The only exception is if the surgeon excises two lesions close together, using only one excision. Source of confusion: Coders may be mixing up lesion excision rules with the rules for laceration repairs, which are different. With laceration repairs, you do add the lengths of tissue repaired and bill one code. With lesion excision, you should calculate the size of the excision by measuring the size of the lesion plus the size of the margins necessary to ensure a clean margin. Why? [...]