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Integumentary Coding Question

  1. Default Integumentary Coding Question
    Medical Coding Books
    I am not sure if I have interpreted this correctly. In the Integumentary section of the CPT book under excision of benign or malignant lesions (page 53 or 54 of the 2007 book), it says that if a closure requires an intermediate or complex closure, you need to report the excision in addition to the appropriate intermediate or complex closure codes. Does that mean that the intermediate or complex closure code is coded first and the excision is coded second? Also, what modifier would you use on the second code, a -51 or a -59?

    I'd appreciate anyone's thoughts on this. Thanks in advance.

    Sheryl Kinne, CPC
    Last edited by Skinne; 06-01-2007 at 11:50 AM.

  2. #2
    first code the closure, then lesionwith -51.
    Last edited by Donna SanGiovanni; 06-07-2007 at 10:14 AM.

  3. #3
    Default Closures with Lesion Removal
    When coding a intermediate or complex closure with a lesion removal, you would code the Closure first as it has a higher RVU then the actual lesion removal code. You would place a modifier 51 on the lesion code and expect the appropriate reimbursement as such. Hope this helps. I code these everyday.
    Susan Ward, CPC, COC, CPC-I, CEMC, CPCD, CPRC
    AAPC ICD-10 Expert Trainer

    A small act of kindness a day can make someone's day special

  4. #4
    Stuart Sailfish Chapter
    coding a intermediate or complex closure with a lesion removal I code the closure then the lesion removal, My MD's do these on a daily basis as well.
    they were a little confusing as first, but once you get a few dozen under your belt you'll be good to go.
    Candice Fenildo, CPC, CPMA, CPC-I, CPB, CENTC, CRHC, AAPC Fellow
    Director of Operations
    Ear, Nose and Throat Associates of South Florida, PA

    "Nothing is stronger than the heart of a volunteer"

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