It looks to me as though the excision (11403) was the approach for the removal of the lipoma (21930), and not 2 separate procedures. Once a definitive procedure is performed (21930) you cannot charge for the approach (11403), and there was only one closure as there is only one defect created, and the 21930 includes the closure.
Now there is a debate amongst experts in the field as to whether this type of scenario should use the 11403 OR the 21930 here is an excerpt from the Family Practice magazine:
According to CPT, there are actually a number of differences between 11403 and 21930. Code 11403 is for “excision, benign lesion, except skin tag (unless listed elsewhere), trunk, arms or legs; lesion diameter 2.1 to 3.0 cm,” and it appears in the “surgery/integumentary system” section of the CPT manual. It is for full-thickness (through the dermis) removal of benign lesions of the skin or subcutaneous tissues (e.g., cicatricial, fibrous, inflammatory, congenital and cystic lesions), including local anesthesia and simple (nonlayered) closure. Code 21930 is for “excision, tumor, soft tissue of back or flank,” and it appears in the “surgery/musculoskeletal system” of the manual. In the Medicare Fee Schedule database, 11403 has a 10-day global period and 21930 has a 90-day global period, suggesting that 21930 is a more extensive procedure.
There is nothing in the descriptor of 21930 that would obviously preclude its use in your situation. A lipoma is a fatty tumor, and the physician did excise it from the soft tissue of the back. The only indicator that this code may not be appropriate is the 90-day global period that Medicare attaches to this procedure. Services with a 90-day global period typically represent more involved procedures that are not usually done in a physician’s office. You may want to review your service in light of the information provided above to decide which code most accurately identifies it.
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