Internal Medicine Coding Alert
Modifier to Report Destruction and Excision Procedures
PDF
Question: One of our physicians destroyed a premalignant lesion on a patient’s arm and excised a benign lesion on the patient’s other arm. Can I report both the destruction and the excision per CCI?
Answer: You’ll have to report the destruction of the premalignant lesion with the CPT® code 17000 (Destruction [e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement], premalignant lesions [e.g., actinic keratoses]; first lesion) and report the excision of the benign lesion using the CPT® code 11400 (Excision, benign lesion including margins, except skin tag [unless listed elsewhere], trunk, arms or legs; excised diameter 0.5 cm or less).
As your physician performed the excision and the destruction on two separate lesions, you should have no trouble getting reimbursed for both the procedural codes if the modifier 59 is appended to inform the payer that two separate and distinct procedures were performed.
Vancouver Subscriber
However, these two codes are bundled as per Correct Coding Initiative (CCI) edits with the modifier indicator ‘1.’ Since the modifier indicator is one, you can unbundle the codes by appending a modifier. So, you’ll have to append the modifier 59 (Distinct procedural service) to the code 11400.
Internal Medicine Coding Alert
- CPT® 2014 Update:
New E/M and Ultrasound Wound Care Therapy Codes in 2014
Good n ews: Common TCM guidelines will rid confusion while reporting transitional care. Be prepared [...] - 2014 Physician Fee Schedule:
Possibility of Fee Deductions If Proposed MPFS Gets Accepted
Sunny side: Chronic care non-face-to-face services might bring in bonuses in 2015. While the proposed [...] - ICD-10 Update:
Bust Major ICD-10 Myths and Mysteries
Don’t assume that ICD-10 will allow you to use the same code twice. With the [...] - You Be the Coder:
Choose Appropriate Vaccine Administration Codes
Question: Rotovirus vaccine is only given to children less than the age of eight at [...] - Reader Question:
EF Modifier For EPSDT Examination Codes
Question: We are receiving denials from Medicaid stating 92551 (hearing exams) which we perform during [...] - Reader Question:
Supply Codes Can Be Reported With Administration For Depo Provera
Question: Our FP saw a patient for her third Depo Provera shot. What is the [...] - Reader Question:
Modifier to Report Destruction and Excision Procedures
Question: One of our physicians destroyed a premalignant lesion on a patient’s arm and excised [...]