Your Docs aren't telling you what type of lesions are being removed, other than the site. This makes a BIG difference. I see he/she has listed the sizes of the lesions (there are 3 based on the report) as well as the size of the repairs/defects. Benign excisions are 114XX range and Malignant ones are 116XX range.
I would recommend you wait until you receive the Pathology report back as that should tell you what was found and will prevent you from filing one way and then having to correct it with the insurance carrier.
EX: If your Dr. says benign lesion removed, and then the path report comes back stating malignant (SCC, BCC, Melanoma) you have then filed the incorrect code, affecting payment.
And vice versa if the Dr. states malignant and the path report comes back stating something like dysplastic nevus, then you've filed malignant in error when that is really considered benign. (And the carriers will be wanting their money back, lol!)
**Note: It is very important for your Dr's to also mention the depth they are excising down to. This will tell you whether to choose from the Integumentary section of the CPT book or the Muscoskeletal section. See the CPT Assistant from April, 2010 titled " Integumentary vs Muscoskeletal Lesion Excisions" for details.
Last edited by CoderinJax; 02-25-2011 at 12:57 PM.
Reason: added clarification
Becki, CPC, CPMA, CGIC, CHONC, CPCD