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Wiki Complex Repairs

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LadyT

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Local Chapter Officer
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Broadway, VA
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I am wondering If my Dr can bill for both a complex repair and a excision of a malignant lesion? I see that CPT states you can not. My reason for questing is because we just went from paper charts to EMR and our EMR system picks those codes (complex repair with malignant excision) and in the past our repairs were intermediate, this is the first complex we have done. Any help or experience of what someone else bills would be helpful. I am in Virginia. Thank you in advance!
 
Just make sure that the provider is really meeting the criteria for "complex" repair.

You may want to invest in a subscription to DermCoder. If DermCoder tells you to put a 59 modifier on a code, that means you shouldn't bill it unless it's on a different lesion. It also includes a full listing of the CCI edits. I don't know what you're referring to in the CPT book (because it sounds incorrect), but the CCI edits will tell you definitively.
 
Thank you for your response! I was having a really "off" day... the CPT book definition states complex repair DOES NOT include excision.:eek:
 
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