Progress Report: Destruction of lesion using scrape/shave biopsy AND electrocautery. Destruction of 3 lesions on back.

Path Report:A)11x9x4 mm shave biopsy lower back
B) 6x4x4 mm shave upper back
C) 6x5x3 mm shave upper back
D) 6x5x3 mm shave upper back

Doctor coded as 11300 and 11300-59 x2
Medicare has denied the 2 additional units and someone appealed to Medicare and they denied the appeal stating documentation did not support the performance in question.

1st Does the doctor need to elaborate on the progress notes?
2nd Were the correct codes used?
3rd Why does path show 4?