Wiki Coding question...

[darin248]

The physician excises two benign lesions from a patient's back; one measuring 3.2 cm diameter and one measuring 2.4 cm excised diameter. Both areas of defect are closed with a simple closure. What would the correct code be?

a. 11404, 11403-59
b. 11406, 12002
c. 11404, 11403-51
d. 11404, 11403-59, 12002


I believe it would be C, because it needs to have a modifier 51 appended to it, but i just want to make sure! Taking the exam on Saturday, and I'm picking at my brain as much as i can! Thanks for your help!!

 

[elenax]

I work for an ASC and we don't use the 51 modifier...if it was a simple "non layered" closure I go with letter "a".

 

[kumeena]

I go woth answer "A"

 

[mitchellde]

If those are the only choices then it would be A. But if you are inclined to use the 51 then it would be appended as a second modifier after the 51. You need the 59 to identify the second procedure as a distinct and separate procedure and not bundled with the larger of the two, the 51 communicates that both were performed at the same session. I hope this helps you with the difference between the two

 

[Lisa Bledsoe]

The answer would be A with modifier -59 because they are separate lesions.

 

[magnolia1]

I would say 11404 & 11403 (no modifer on either).
The lesion size noted in each code description differentiates the two codes.

 

[mitchellde]

without the 59 modifier the smaller excision will bundle into the larger.