Wiki medicare denial on repair

paula f3

Guru
Messages
142
Best answers
0
Physician excised 3 lesions from back, right, left and central area, all separate excsions, did a layer closure, then did another excision on the neck with a layered closure. I coded the back lesions separately, (11403,11402-59,11402-59, and the layered closure 12032. The neck lesion was 11423-59 with the layered closure 12031-59.
Medicare is denying CPT 12031 stating that procedure can never be reported with code 12032 due to CCI column 2 edit.
The neck lesion is a totally different anatomical part and the diagnosis was not the same as the diagnosis for the back lesions, per pathology.
Please help my understand .

Paula
 
Top