Wiki Coding Lesion Removal

[kathy a]

Is there a decision tree for Lesion Removal ? My doctor does Lesion Removals. He mainly uses CPT # 67810 or # 67840. When the biopsy is more than superficial my note says to use # 67810 . When the entire lesion is removed use #67840. This code involves lid margin, tarsus and palpebral conjunctiva. For the # 67840 he will state full thickness through the dermis for the removal of the lesion. The issue I have is the pathologist may state Excision of Skin which makes me think it should be the codes from the Integumentary System-11102-11107,11440-11446 ? How do I know what codes should be used ?

 

[natashalage]

Hello, I am not an expert and still learning this specialty. I would bill what is documented in the Op note: size, depth, margins etc, so we, coders, can get the best descriptive CPT. If you have time, you can bring this discrepancy to MD, so he/she can speak to pathology team to improve the documentation. Again, I am not an expert. Good luck to both of us!