March 4, 2021 Question: My physician excised a lesion the was 1.5cm on the trunk. He documented it as a benign lesion but sent it to pathology for confirmation. We submitted CPT code 11402 for the benign lesion of the trunk. The lesion came back malignant. Shouldn’t we wait for the pathology report prior to...
Category: CC-Dermatology
Mohs Surgery Performed the Same Day as a Biopsy
February 18, 2021 Question: A patient was referred to our Mohs surgery for a lesion on the cheek. The family practice doctor did not do a biopsy but suspected skin cancer. My doctor does not think we can bill for the biopsy the same day as Mohs and says it is bundled into the Mohs...
Excision of Rheumatoid Nodules
February 4, 2021 Question: I excised a rheumatoid nodule on both the left and right elbow. What CPT code do I report? Answer: You would report CPT code 24120 (excision or curettage of bone cyst or benign tumor of head or neck of radius or olecranon process). You can report this procedure when performed bilaterally....
Coding Intermediate Repairs
January 21, 2021 Question: Can I report CPT 12052 for an intermediate repair of the cheek and nose. The size of the defect of the cheek is 2.7 cm and the defect on the nose is 1.0cm. I want to code 12052 for the cheek and CPT code 12051-59. Is that correct? Answer: If both...
Wedge Excision with Reconstruction
December 17, 2020 Question: My physician did a full thickness wedge excision with an Estlander flap of the right upper lip with reconstruction utilizing a cheek flap, adjacent tissue transfer. The defect measures 27 sq. cm. The physician used a mucosal graft from the wedge excised from the lip with reconstruction of the vermillion of...
Paring or Cutting
December 3, 2020 Question: I am new to Dermatology coding and need some help. The previous coder told me for CPT 11055 (paring or cutting) that if more than one is removed we bill the codes 11055 and 11056? My physician removed 4 calluses by cutting and I billed CPT 11055 and 11056. The claim...
New 2021 Evaluation and Management Code Guidelines
November 12, 2020 Question: I heard that the E/M code guidelines are changing in 2021. Will this apply to all E/M codes? Answer: Good question. The 2021 changes will NOT apply to all E/M codes. The 2021 changes apply only to the new patient, 9920x, and established patient, 9921x, categories of codes. That means you...
Excision of Cyst
October 29, 2020 Question: I need some help. The physician made an incision over a cyst was able to remove the contents in total or by piece meal. Would this be considered an excision of a benign lesion? Answer: Yes, it would be considered a benign lesion excision using a code from category 11400-11446. Make...
MOHS with an E/M Service
October 15, 2020 Question: A Medicare patient came in last week and my doctor did a biopsy on the chest and it came back malignant and meets the Medicare criteria for MOHS surgery. The patient came in today and he performed a level 3 E/M visit and did MOHS surgery in 2 stages. I am...
Lesion on Eyelid
October 1, 2020 Question: Can I report CPT code 67850 when liquid nitrogen is used to destroy a lesion in the lid margin? Answer: The CPT code definition for 67850 specifies the lid margin (Destruction of lesion of lid margin (up to 1 cm). If the lesion is in the margin, report CPT 67850 but...