question on closures

BABS37

Expert
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Des Moines
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If a patient comes in for an excision of a perineal skin lesion and the physician performs intermediate closure, can the closure be coded as well? I chose CPT 11422 and under those guidelines, it says to 'code also intermediate closure (12031-12057) so I chose 12041. No where does it say it's a Medicare CCI edit... Any advice if this is wrong or acceptable to bill out?

Thank you!!!
 

grth97

Networker
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These procedures include simple (non-layered) closure. If intermediate (layered) or complex closure is necessary, see 12051-12057 or 13131-13153. Yes you can code it.
 

BABS37

Expert
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Ok thanks. I did code both but Medicaid is denying it saying they are included and will not pay for the intermediate closure as a CCI edit. Guess I'll be calling :) Thank you for your answer!
 
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