CPT^® 11303, Under Shaving of Epidermal or Dermal Lesions Procedures

The Current Procedural Terminology (CPT^®) code 11303 as maintained by American Medical Association, is a medical procedural code under the range - Shaving of Epidermal or Dermal Lesions Procedures.

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Summary

The provider shaves off a single epidermal or dermal lesion greater than 2.0 cm in diameter from the skin of the trunk, arms, or legs.

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Shave Excision greater than 3cm

A shave isn't an excision - it's a different technique entirely. (See the CPT defintion: [I]Shaving is the sharp removal by transverse incision or horizontal slicing to remove epidermal and dermal l... [ Read More ]

Not medically necessary denial

Thanks for all of the input! I did find out that per our LCD's for Ky, 11303 is restricted to benign lesions only. However, per the CPT book it is not for benign lesions only.... [ Read More ]

Not medically necessary denial

Just on the surface this is an odd denial. Not knowing any details I would suggest this be appealed with the documentation. 11303 with a dx of 173.51 should not hit any edits. Deb's assertion that 11... [ Read More ]

Not medically necessary denial

11303 is not restricted to benign pathology it is a shave removal code. You cant use an excision code unless the documentation supports an excision. It is a matter of how much tissue was removed for... [ Read More ]

Not medically necessary denial

I think the problem may be that 11303 is a benign lesion removal code and you're billing it with a malignant lesion diagnosis, so of course that diagnosis is not going to be included in the benign les... [ Read More ]

Not medically necessary denial

It sounds like the patient was there for a lesion bx. If so I bill cpt 11000 with a dx of 173.51. I normally hold the charge until the path report comes back with results. I would not bill 11303 unl... [ Read More ]

Not medically necessary denial

Patient had a lesion removed (shave removal) off of their back, and pathology came back as Basal Cell Carcinoma. We billed 11303 with diagnosis of 173.51 to Medicare, and it was denied not medically n... [ Read More ]

Code the following

This is what I come up with: Benign Nevus of the breast: Dx: 216.5 (Benign neoplasm, skin, breast) CPT: 11300-11303 _depends on the size (Shaving of a single lestion, trunk) Skin tags: DX 701.9 (Un... [ Read More ]

August Chapter Newsletter

Sorry for the late posting!! Getting Ready for 2013 It may seem a little strange to ask you to get ready for 2013; we are after all, only beginning the 8th month of 2012. While most of us would agr... [ Read More ]

Derm coding 11300-11303 & 11305-11308

No CCI relationship between 11303 and 11308. Modifier not needed. Depends on insurances. We have some that require multiple units and no modifier. Like I said...its better to check with your payers.... [ Read More ]

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