AAPC - Back to school
Results 1 to 4 of 4

Thread: How to charge for 2nd, 3rd, & 4th procedure

  1. #1
    Join Date
    Apr 2007

    Default How to charge for 2nd, 3rd, & 4th procedure

    AAPC: Back to School
    If a patient was to have and excision of a cyst in the breast this would be code #1, with closure layered intermediate #2, excision of cyst in neck code # 3. Code one would be full price, code 2 would be 1/2 price, and code 3 would be ?

  2. #2
    Join Date
    Apr 2007
    Hartford, CT


    Charge your full price for all procedures, the insurance company will take the discounts according to their policies. Usually full allowed amount for the first procedure, 50% for the 2nd and 25% for each additional. You should check with the payer to find out how exactly they pay for multiple procedures.

  3. #3
    Join Date
    Apr 2007


    I agree with dclark7. Don't forget to list your charges by RVUs, list the highest ones first. You can get your RVUs from the CPT coding companion, or from websites like mediregs.com or code correct. I think Medicare may list them on their website as well.

  4. #4
    Join Date
    Apr 2007
    Milwaukee WI

    Default Closure may NOT be separately billable

    Depending upon which codes you are using for the excisions (skin lesions vs breast cyst vs musculoskeletal codes for neck cyst) the closure of the surgical wound MAY be included and not separately coded.

    CPT 19120 (excision breast cyst) and CPT 2155X (excision tumor, soft tissue neck) both INCLUDE closure of the operative wound.

    Excision of SKIN lesions (CPT 114xx for Benign lesions; CPT 116xx for Malignant lesions) DO allow for separately reporting intermediate or complex closure.

    Be sure to read your guidelines.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

Similar Threads

  1. 3rd and 4th degree laceration / vaginal delivery
    By lajalex0708 in forum OB/GYN
    Replies: 6
    Last Post: 04-01-2014, 02:28 PM
  2. Interphalangeal joint arthrodesis, 2nd and 3rd toes
    By lizzardb in forum Orthopaedics
    Replies: 2
    Last Post: 07-15-2013, 11:13 AM
  3. Facility charge for E&M and procedure
    By 01051184 in forum Emergency Department
    Replies: 2
    Last Post: 10-06-2011, 02:09 PM
  4. D&E Molar pregnancy- 2nd procedure
    By rachell1976 in forum OB/GYN
    Replies: 4
    Last Post: 04-26-2011, 08:55 PM
  5. 3rd & 4th degree episiotomies
    By gojocpch in forum OB/GYN
    Replies: 1
    Last Post: 04-11-2011, 04:34 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?


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.