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Excision 11623 denied with pedicle flap 15736

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abaer01

Contributor
Messages
19
Location
Melrose, FL
Can someone please assist with this? I'm having trouble finding info on whether the excision of a malignant lesion 11623 is included in the pedicle flap code 15736. I don't see any CPT or NCCI issues, but Aetna denied 11623 as included. The lesion was excised from the finger and pedicle flap taken from the wrist.
 
Well, according to the CPT instructions in order to be paid for both procedures they have to be from separate body areas so site modifiers make sense to me.
 
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