If he does both the same day, then no. Can't code an E&M unless he does something separate and in addition to removing the lesion that would support the use of mod -25
But if the patient comes in and says I want this taken off, the phsyician looks at it and says yea, we'll just do a simple shave and then takes it off, then there is nothing to support a "significant separate E&M service"
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