Wiki 27618 Question.

[nikkisgranny]

Doc performs an excision of three separate soft tissue lesions. Each incision was carried down to the sub q.

I am able to bill 27618 X3 or just once?

Any suggestions?

 

[ciphermed]

It appears that coding 27618 x 3 would be appropriate as what is described includes; 3 separate lesions & 3 separate incisions.

Both CPT and Medicare's definition for the appropriate use of modifier -59 include separate incision/excisions, separate lesion as criteria for use of the modifier.

In addition the code descriptor indicates
27618 Excision, tumor, leg or ankle area; subcutaneous tissue

as opposed to tumor(s).

See CMS "Modifier 59 Articleroper Usage Regarding Distinct Procedural Service
http://www.cms.hhs.gov/NationalCorrectCodInitEd/

Hope this helps,

 

[nikkisgranny]

It does. I didn't pay too much attention to the verbage but you are correct.

 

[mbort]

careful..if the incision was just "down to" the subq you may be looking at integ codes rather than 27618. To qualify for 27618, the incision needs to go "into/through" the subq. Minor technicallity