I know that you are supposed to code the lesion removal itself (for example 11422), and it says that it includes a "simple, nonlayered" closure but to add another code for "intermediate closure or complex closure."

I have a hard time charging some of these patients for the lesion removal plus the closure...my doc doesn't use a simple closure on ANYBODY. He always puts at least one suture inside.

I guess my question is...what constitutes a "simple" closure versus an "intermediate" closure? Does the single suture inside still constitute the "simple" closure? I've looked on line for a definition of either and can't find it.

I had one this morning where a 0.5 cm (1 cm wound) lesion was removed from a toe, and it charges out as $342 for lesion removal...but $573 for closure. This mom is not going to be happy, especially when she could have had it destroyed for a lot less.

Thanks for any help.