it's difficult to help without reading the complete note. Could you post the note? (without the name of course)
from what you've written:
1) of course we can't code "rule outs" or "probables" - so go with lesion codes and signs/symptoms (irritated/inflamed)
2) I don't see codes for the shave removals - 11100-11101 are not shave removals.
3) I don't see a size mentioned
4) I'd go with the lowest sized shave excision codes for the area's since no size was stated. 11300 for the shave excision under lt breast - No idea where the skin tag was that was shaved off but "where-ever" that code too.
5) was the patient going to the provider "just for" removal, was it a consult, a referral?
6) I'd code the removals ONLY before I coded an E/M only.
Of course this info comes from ONLY what you've written - ONLY what I've read
my advice could change once you post the note!
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