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Multiple Lesion Removal

  1. Default Multiple Lesion Removal
    Medical Coding Books
    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?
    Sherry Sandvig
    Office Manager
    Dr. Vaughn and Dr. Batayola

  2. #2
    Stuart Sailfish Chapter
    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
    Last edited by Candice_Fenildo; 07-17-2007 at 07:20 PM.
    Candice Fenildo, CPC, CPMA, CPC-I, CPB, CENTC, CRHC, AAPC Fellow
    Director of Operations
    Ear, Nose and Throat Associates of South Florida, PA

    "Nothing is stronger than the heart of a volunteer"

  3. Default
    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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