Wiki billing closure of benign lession

[hudsondna]

a co-worker of mine said that she had heard that if the physician does a excision of a benign lession with complicated closure, you can not bill both the excision and the closure.
i was under the impression that if a complicated closure was performed that both the excision and the closure are billable. the only time a closure is not covered is for simple closure.
am i correct? or my coworker? or are we both wrong?

 

[code3jill]

answer is in the cpt code book under excision-benign lesions: repair by intermediate or complex closure should be reported separately. you are correct.

 

[JessicaHeemskerk]

Yes you are correct. The excision and repair can be billed separtely unless a simple repair is done b/c this is included with the excision.

 

[FTessaBartels]

But you may still get a denial

But don't be surprised if you get a denial. This happens to us all the time. Even with a -59 modifier on the repair they get denied.

I appeal every one with a copy of the op note and CPT pages.

F Tessa Bartels, CPC, CEMC