Wiki Excisions

[MsMaddy]

IF THE PATIENT COMES IN FOR EXCISION OF SKIN LESION ONLY AND THE NURSE DOES THE VITAL SIGNS CAN WE USE EM LEVEL WITH MODIFIER 25.

EXAMPLE :


DIAGNOSIS 239.2

99212 - 25 THIS IS FOR OBTAINING VITAL SIGNS
17004 - 15 OR MORE LESIONS


THANKS IN ADVANCE
MsMADDY

 

[eadun2000]

IF THE PATIENT COMES IN FOR EXCISION OF SKIN LESION ONLY AND THE NURSE DOES THE VITAL SIGNS CAN WE USE EM LEVEL WITH MODIFIER 25.

EXAMPLE :


DIAGNOSIS 239.2

99212 - 25 THIS IS FOR OBTAINING VITAL SIGNS
17004 - 15 OR MORE LESIONS


THANKS IN ADVANCE
MsMADDY

No you cannot charge because a nurse does vital signs... that wouldn't even constitute a 99212 to begin with. If the patient presented with skin lesions that he wanted the doctor to look at and the doctor examined and actually documented an exam and they decided to freeze the actinic keratoses, then yes you could bill an E&M with mod 25. However, you state the patient came in specifically for the excision and only thing documented was the nurses vital signs and the procedure, then no way. All you can code is the procedure.

 

[mitchellde]

I absolutely agree with the above, in addition I question the dx code you have chosen. Neoplasm unspecified is generally used as a working dx when the physcian makes a dx on the basis of a preliminary test which shows the anomaly to be a tumor which has yet to be determined as to its morphology. It is not a fall back code when you do not have a payable dx. be certain the documentation will support that dx.

 

[eadun2000]

I absolutely agree with the above, in addition I question the dx code you have chosen. Neoplasm unspecified is generally used as a working dx when the physcian makes a dx on the basis of a preliminary test which shows the anomaly to be a tumor which has yet to be determined as to its morphology. It is not a fall back code when you do not have a payable dx. be certain the documentation will support that dx.

LOL.. I never even looked at the dx... never even saw it... guess i skipped right over it. Good call Debra! Just want to add you cannot code 17004 unless they are premalignant lesions, such as actinic keratoses. Just an FYI.