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Lipomas

G

gail181

Contributor
Messages
10
Location
Bronx, New York
We received a denial from Capital Blue Cross PPO for both codes 11401-3 units & 11402-4 units that were billed out to the payer. The denial is CO151(Info. does not support frequency services) /CO59(concurrent/multiple guidelines apply). The note states: "1 right upper thigh lipoma removal and 6 left upper thigh removal. Of the lesions that we removed, 3 were in the range of 7 to 8 mm and 4 were 1.2 to 1.6 cm in diameter. Wounds were irrigated and then closed with 4-0 Ethilon".

I am thinking the codes used are wrong and the office should've used 27327-RT AND 27327-LT, 27327-59 OR XS.

What would be the correct coding for this encounter?
 
Is that the whole note? The provider should really be stating to what depth they excised in order to correctly code it, such as dermal, subcutaneous, subfascial. I believe lipomas are most commonly seen in the subcutaneous level, but the provider needs to document it for correct coding.
 
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