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Thread: 54060 & 54057 billed together

  1. #1

    Question 54060 & 54057 billed together

    AAPC: Back to School
    Can 54060 & 54057 be billed together, per cci 54060 is mutualy exclusive to 54057 but a modifier is allowed. What does mutually exclusive mean anyway?

    Thanks for your support

  2. #2
    Join Date
    Apr 2007
    Cottonwood, AZ

    Default Mutualy exclusive

    so here is the definition of the 54060:
    The physician excises selected large lesions of the penis not removable by other methods. After adequate local anesthesia has been administered, the physician cuts out an elliptical piece of skin that includes the lesion and a rim of normal tissue. With a forceps or hemostat clamp, the physician grasps and elongates the involved skin containing the lesion, causing the tissue to tent. Using a scalpel or scissors, an ellipse of tissue containing the lesion is excised. The resulting defect is closed with sutures.

    the definition of 54057 is:
    The physician treats skin lesions of the penis by local application of liquid nitrogen or the use of a cryothermal instrument (54056) or by laser beam (54057) to kill the diseased tissue or the organism. Using a cotton-tipped applicator dipped in liquid nitrogen (-78 degrees Celsius), the physician freezes or burns with the laser only the specific lesions. No tissue is removed and no closure is required.

    if they are allowed with a modifier it means that your treating physician would have to document very well the locations of the lesions and method(s) used to treat the lesions.

    The definition of Mutually Exclusive means that they can not occur at the same time with the same outcome. (laymans dictionary terms) the medicare website might have a better definition of this for this instance.

  3. #3


    If you are using two different methods to treat these lesions, would the (I'm sorry I don't have my CPT book in front of me) the complex treatment work better for the situation? Maybe it's worded as mutliple methods of treatment?

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