Results 1 to 6 of 6

Benign Lesion Excision

  1. #1
    Default Benign Lesion Excision
    Medical Coding Books
    Ok, I am obviously having a major brain meltdown this Monday morning.

    Two benign lesions, eyelid, both eyes. Use one code (11440) and total up the sizes or you code both separately????

  2. #2
    Default Benign Lesion
    To my knowledge it should be 11440 (coding for the appropiate the size of lesion) twice with a modifer 59 to the second cpt code... "Adding codes" together would be for "laceration repairs" both of the same code category.

  3. #3
    Default
    Quote Originally Posted by TLC View Post
    To my knowledge it should be 11440 (coding for the appropiate the size of lesion) twice with a modifer 59 to the second cpt code... "Adding codes" together would be for "laceration repairs" both of the same code category.
    I have to say that I agree with TLC regarding the 11440 code, but disagree with the modifier. 59 is for a staged procedure, whereas the more appropriate code would be 50 for bilateral procedure performed at the same session. Hope this helps

  4. #4
    Location
    Columbia, MO
    Posts
    12,843
    Default
    Quote Originally Posted by cbcofri View Post
    I have to say that I agree with TLC regarding the 11440 code, but disagree with the modifier. 59 is for a staged procedure, whereas the more appropriate code would be 50 for bilateral procedure performed at the same session. Hope this helps
    59 is not for a staged procedure it is for a distinc and separate procedure and is appropriate for this scenario, 50 is incorrect as eyelids are not a paired organ. In fact there are 4 separate eyelids and are identified by modifiers E1-E4, however for lesion removal most payers will not accept these modifiers so we use the 59.

    Debra A. Mitchell, MSPH, CPC-H

  5. #5
    Location
    Milwaukee WI
    Posts
    4,466
    Default Code each lesion
    You code each lesion separately. Codes in the integumentary section are not subject to the bilateral modifier (with the exception of those specifically involving breast surgery). The skin doesn't have laterality.

    -59 would be the appropriate modifier to use to the second (and subsequent) lesion excision codes.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  6. #6
    Default
    CPT 11440 has a bilateral indicator "0", so you can not bill it with 50. See RVU file from CMS for reference. And to avoid a denial (in case payor does not want to see 59 on this cpt) just sent the claim with Op report atached. This will help.

Similar Threads

  1. Benign Lesion excision
    By god4me in forum Dermatology
    Replies: 3
    Last Post: 08-13-2015, 10:51 AM
  2. Excision of benign lesion - Need help
    By jemimah crescentia in forum General Surgery
    Replies: 7
    Last Post: 03-29-2015, 05:13 AM
  3. Surgery benign lesion and hemangioma excision
    By whitefield13 in forum General Surgery
    Replies: 0
    Last Post: 05-23-2013, 02:16 PM
  4. benign lesion excision with int. closing code
    By iryshre@yahoo.com in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 02-12-2013, 09:37 AM
  5. Excision benign lesion on breast
    By Krisb615 in forum General Surgery
    Replies: 1
    Last Post: 12-04-2012, 01:41 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.