Month: August 2016

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Excision of Scar

Patient comes in for what they are calling scar revision and the note states that “standing cutaneous excess of the left abdominal scar” was sharply excised. We are billing with a diagnosis of hypertrophic scar (L91.0) and CPT codes of 11406 (excision of benign lesion) and 12034 (intermediate repair) for the procedure. On speaking with a co-worker regarding the note, since I’m new to plastics surgery, we are wondering if we should bill 15830 with 52 modifier because it appears to me that the excess skin is being removed. What do you think?

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Orthopedic Spine Coding

We have a billing company for which we bill for many different specialties. We have an orthopedic spine doctor who insists we bill the cage code 22851 for each inter-space. However, the CPT book lists as cage(s) therefore our thinking is that no matter how many are placed this code is only allowed one time per surgery. His note states “C3-C4, C4-C5, C5-C6 anterior cervical interbody fusion using PEEK titanium interbody spacers.”

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Excision of Skin Lesion

I heard you say at a course (you were great, by the way. I learned a lot from you!) that we should wait for a pathology report before billing for excision of skin lesions. Please explain why. This may be why I’m not getting paid.

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