Excision lesions benign/malignant

Hopp

Guru
Messages
228
Best answers
0
When coding excision lesions benign/malignant with a layered closure do I need to append the layered closure with a modifier as I have been getting denials from Medicare and was told that I did need the modifier and that there are 4 that I would be able to use 58 being one of them. Is that true? Thanks:)
 

cmartin

Guru
Messages
204
Best answers
0
It sounds like you're talking about doing the layered closure at the same time as the lesion excision, and in that case, I don't know why they would be wanting a -58, which is for use when the second procedure is performed in the post-op period of the first, ie on a different date. The only modifier that would generally apply on the same date, same lesion, is the -51. I think I would call them again and see if you get a different answer!
Connie Martin CPC-GENSG
 

bamiller

New
Messages
3
Best answers
0
I bill a lot of lesion removals. If you are removing more than one lesion from the same anatomical site you must report each removal separately. The insurance company will deny the second, third or fourth code as duplicate service. You will need to append a 59 modifier to the second etc code in that site. Your layered closure code would not be affected since you add the lengths for each group of anatomic sites. Example: 11402, 11402-59, 11402-59 and 12032 would be your codes for three benign lesions removed from the trunk
(1.1-2.0cm) with intermediate layered closure totaling 6cm.
 
Last edited:
Top