Multiple Lesion Removal

ssandvig

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I have 5 lesions that were removed and sent to patholgogy. Left
shoulder, lower mid back, left side of back, left small of back, and
abdomen. They all fall under the CPT according to there size and they all have the same pathology diagnosis so would I use one
CPT code and use quanity of 5?
 

Candice_Fenildo

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A little more info would be needed before determing a code. what was the diagnosis, and how were the lesions removed, Ex: cryo, or excision? it also depends on the insurance carrier.

I would love to help just need to be a bit more specific :)
 
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elane15

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If you are referring to the lesion excision codes (benign or malignant), my experience has been that they are not billable as units (CPT times 5). I did have luck billing them individually for each lesion with a modifier 59.

CPT Dx
CPT mod 59 Dx
CPT mod 59 Dx
CPT mod 59 Dx

This is providing that the CPT being billed is all the same. If the lesion size is different or location is different warranting a different CPT code than a 51 modifier would be used in place of the 59.
 
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