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Thread: skin neoplasm/medicare

  1. #1

    Unhappy skin neoplasm/medicare

    AAPC: Back to School
    Can anyone tell me what is the cpt code for medicare pt who had a "excision of skin lesion of less 1cm on the back " I'm not sure which HCPCS code to use. Please help!

    Thank you in advance!


  2. #2
    Join Date
    Apr 2007


    This depends on whether it is malignant or benign and the method. Based on what you have listed it is probably going to be either 11401 or 11601 if it was between .6 and 1 cm. Hopefully this will get you in the right direction for your research. If the documentation is too vague you will probably need to go down to the smallest diameter which would be codes 11400 (benign) or 11600 (malignant) .5cm or less.

    Laura, CPC

  3. #3
    Join Date
    Apr 2007


    you also may want to look at 21930...especially the lay description.

    I would not code the malignant/benign lesion codes based on diagnosis codes alone....what really matters (but not for 21930) in most lesion scenarios is the depth of the removal of such lesions.

    Hope this helps

  4. #4
    Join Date
    Apr 2007
    Duluth, Minnesota


    I agree with katmryn78 - based on what you wrote this was a lesion and if not a enough info is given, you have to code the smallest size by default. (or you could request clarification and have the provider amend their dictation to support it).
    Donna, CPC, CPC-H

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