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Lipoma coding of forehead

  1. Default Lipoma coding of forehead
    Medical Coding Books
    How do we get paid for a complex closure of the forehead, 13132 and an excision of a lipoma of the forehead, 21011? According to the CPT manual, complex closures are excluded but the NCCI bundles these.

  2. #2
    Location
    Coastal Coders
    Posts
    47
    Default
    Are you using a modifier on one of the procedures?

  3. #3
    Location
    Milwaukee WI
    Posts
    4,466
    Default Complex closure is included
    I do not see anywhere in CPT where complex closure can be billed separately from 21011.
    CCI bundles these two procedures.

    Excision of SKIN lesions allows you to separately code intermediate or complex repair. Perhaps this is what is confusing you.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  4. #4
    Location
    Ft. Worth, Texas
    Posts
    108
    Default
    You should have used code 11442 and you can bill for the repair also.

    Cathy

  5. #5
    Location
    Columbia, MO
    Posts
    12,840
    Default
    Quote Originally Posted by Biller385 View Post
    You should have used code 11442 and you can bill for the repair also.

    Cathy
    Disagree, the 21011 is correct for a lipoma of the forehead but the closure is inclusive and cannot be biled separate.

    Debra A. Mitchell, MSPH, CPC-H

  6. #6
    Location
    Ft. Worth, Texas
    Posts
    108
    Default
    Deb,
    I may be wrong, but check out Jamie Dezenzo's post of 5/8/09 Titled Part B Insider, Vol. 8 (Coding Institute).

    I may be interpreting the post (article) wrong, but I can see were she states the skin is close to the bone and the general principal does not apply to lipomas on the face and forehead.

    What do you think?

    Cathy

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