1. M

    Well-differentiated neuroendocrine (carcinoid) tumor?

    Hi everyone, I have a patient with a diagnosis of well-differentiated neuroendocrine tumor (carcinoid). In ICD-10, carcinoid is broken down into either benign or malignant, and the default for neuroendocrine is benign with a subterm of malignant poorly differentiated. Well-differentiated is not...
  2. C

    Novitas Solutions JL bundling of benign lesion of .5cm or less with closure

    Medicare is bundling excision of benign lesion .5cm or less with intermediate closure. Based on the CPT manual instructions that intermediate and complex closures should be reported separately, my physician wants to add a 59 modifier to the closure. It is my understanding that Medicare...
  3. A

    11423 VS 21012 scalp cyst

    Can someone help me to determine the difference of 11423 Excision of benign scalp lesion 21012 Excision of tumor/soft tissue of scalp Excised a cyst 2.6 cm and sent for pathology of patient's scalp. I read in one of my coding books that if it were less than 2 cm, I should use 11400 series but...
  4. N

    Diagnosis coding for neoplasms that aren't biopsied

    Hi there, I work in a family practice office and recently had a case occur where the doctor looked at a "mole" and determined it to be a benign neoplasm by its appearance. For diagnosis coding, since the physician is certain it's benign, would you use the benign neoplasm code? Or since there...
  5. S

    Removal of benign lesion

    A patient was seen for removal of a benign skin lesion. I billed the insurance with CPT 11443 (excision benign skin lesion of face/ears/eyelids/nose/lips 2.1-3 cm). I received a denial stating a modifier is required for this code. I am unfamiliar with what modifier I am to use. I would really...