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billing closure of benign lession

  1. #1
    Default billing closure of benign lession
    Medical Coding Books
    a co-worker of mine said that she had heard that if the physician does a excision of a benign lession with complicated closure, you can not bill both the excision and the closure.
    i was under the impression that if a complicated closure was performed that both the excision and the closure are billable. the only time a closure is not covered is for simple closure.
    am i correct? or my coworker? or are we both wrong?
    Anita Hudson, CPC
    Scott and White Bryan/College Station

  2. #2
    answer is in the cpt code book under excision-benign lesions: repair by intermediate or complex closure should be reported separately. you are correct.

  3. #3
    Yes you are correct. The excision and repair can be billed separtely unless a simple repair is done b/c this is included with the excision.

  4. #4
    Milwaukee WI
    Default But you may still get a denial
    But don't be surprised if you get a denial. This happens to us all the time. Even with a -59 modifier on the repair they get denied.

    I appeal every one with a copy of the op note and CPT pages.

    F Tessa Bartels, CPC, CEMC

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