11423 VS 21012 scalp cyst

[aprillerowland]

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 I thought 21012 may be better suited, I just don't want to bill incorrectly. Please advise.

 

[JesseL]

It depends how deep the excision was if you're comparing those two codes. the 14*** is for full thickness excision (up to or into the subcutis).. The 21*** is for deeper excisions up to the soft tissues/muscles I believe.

 

[STKrueger]

soft tissue excision vs benign lesion excision

21012 is a code used for soft tissues like Lipomas (D17._)
11423 is used for benign lesion excisions, other than skin tags.


21012 and other soft tissue excision codes also include SIMPLE and INTERMEDIATE repairs, so you would not want to add the closure unless it was complex, which I have not experienced and we do bill out lipomas frequently. The benign lesion codes 11423 can be used and you can bill the closure, depending on the size, location, medical necessity, etc.