Internal Medicine Coding Alert
Cyst Removal
PDF
Question: The internist excised two sebaceous cysts off of the patient's back. One cyst was 4.7 cm and the other was 3.3 cm. How should I code this? You need to attach modifier -59 to 11404 to show the insurer that the second excision was separate and distinct from the first procedure.
Texas Subscriber
Answer: For the 4.7-cm cyst excision, you should assign 11406 (Excision, benign lesion including margins, except skin tag [unless listed elsewhere], trunk, arms or legs; excised diameter over 4.0 cm). You should report 11404-59 (... excised diameter 3.1. to 4.0 cm; distinct procedural service) for your internist's removal of the 3.3-cm cyst.
Both 11406 and 11404 are appropriate for three reasons:
Internal Medicine Coding Alert
- 4 Examples Show You How to Report HCPCS Codes G0345-G0350 With Confidence
Plus: Why more infusion-coding changes are coming your way in 2006 To make sure Medicare [...] - What the New G Codes Mean For Your Bottom Line
Bonus: Here's how to get paid for same-day injections and E/M services This year, you [...] - You Be the Coder:
Cyst Removal
Question: The internist excised two sebaceous cysts off of the patient's back. One cyst was [...] - NCCI 11.0 Bundles G0345 With Colorectal Screening Codes
The latest edits could mean the difference between payment and denial The National Correct Coding [...] - Use This Chart to Tie New G Codes to 90780-90784
We've saved you the trouble of combing through the Federal Register If you want to [...] - Are You Forfeiting Payment Are You Forfeiting Payment
Say goodbye to your confusion over screening guidelines The next time your internist performs a [...] - Reader Questions:
CMS Changes Venipuncture Coding Requirements
Question: How should I report routine venipuncture to Medicare?
California Subscriber
Answer: Beginning Jan. 1, you [...] - Reader Questions:
Let Time Guide Your Follow-Up E/M Coding
Question: A patient saw the internist to get results on labs and monitoring. The physician [...] - Reader Questions:
First-Time Patient Means New-Patient Codes
Question: A new patient presented for a physician/preventive exam. The patient also had three complex [...] - Reader Questions:
Simple Removal Won't Justify 69210
Question: The internist documented that a patient has "wax bilaterally" and that the nurse removed [...] - Reader Questions:
Get a Grip on Bone-Density Studies
Question: What are Medicare's requirements for reporting bone-density studies?
Pennsylvania Subscriber
Answer: Medicare covers bone-density studies when [...]