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Thread: Help Coding Excision Lesions with Layered closures

  1. #1

    Default Help Coding Excision Lesions with Layered closures

    AAPC: Back to School
    Just wondering if someone would be able to help out on this one. My doc performed Excison of 5 lesions of the back with layered closures I coded the following: 11401 ,and then 11400, 11400-59, 11400-59, 11400-59 and then my layered closure 12034 Insurance company is denying the layered closure due to CCI edits Just wondering what modifier to use the 59 (although its not really separate/distinct) or do I just go ahead and use the 58
    Thanks for any help - Still trying to figure all this out-Its only been 2 yrs and I code and bill for a general surgeon
    Deb, CPC

  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default Appeal with copy of CPC

    We've used both M51 and M59. It seems that no matter which modifier I use (or don't use) the closure gets denied.

    I appeal these denials with the copies of the guidelines direct from CPC ... underlining the direction to code intermediate or complex closure separately. And I also include a copy of the CCI edits, which clearly allows for the closure being separately reported.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. #3


    you should bill each excision with its own repair code, and no do not use mod 58
    example of using mod 58 is when doc puts a port in a pt for chemotherapy tx after surgery and its in a post op period.
    ex: 36561 58
    77001 26

    v58.11 174.9

    have a good one
    hope this helps

  4. #4


    The intermediate repair code specifically states to add the sum of the length of repairs together if they are in the same location(the back) I would use one repair code with a 51 modifier.

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