April 2, 2020 Question: Now that we aren’t limited to HIPAA compliant software, can we use any app or platform to conduct a telemedicine visit? Answer: You may use any app or platform that is not “public facing” according to HHS. Platforms such as Facebook Live, Twitch, and TikTok are considered public facing. Skype, FaceTime,...
March 19, 2020 Question: What diagnosis code is reported for yeast dermatitis? Answer: You would report B36.8 (Other specified superficial mycoses) for yeast dermatitis. *This response is based on the best information available as of 3/19/20.
March 5, 2020 Question: Would I code a melanocytic nevi of the right shoulder with ICD-10-CM code D48.5? Answer: No, you would not use D48.5 which is neoplasm of uncertain behavior. The only time you would report D48.5 is when you have confirmation from a pathology or histology report stating behavior is uncertain or unpredictable....
February 20, 2020 Question: My physician sees a patient for a skin cancer screening. What diagnosis code should I use for a screening? Answer: The diagnosis code for skin cancer screening is Z12.83 (Encounter for screening for malignant neoplasm of skin). *This response is based on the best information available as of 2/20/20.
February 6, 2020 Question: We have been billing malignant lesion excisions and ATT’s separately and we were getting paid. Now the payor is requesting a refund for the lesion excisions for these cases. Can we appeal this? Answer: If a lesion is excised and an adjacent tissue transfer or rearrangement is performed at the same...
January 23, 2020 Question: What CPT code should you report for laser removal of a keloid scar? What should be documented in the procedure note? Answer: You would report 17110. Documentation should always include: Indications for procedures Risks/Benefits Document location of lesion/keloid destroyed CM size of lesion before removal/destruction Method of destruction Detail of the...
January 9, 2020 Question: My provider insists on calling some lesions uncertain behavior because he is suspicious of cancer. This is before the pathologist has given a report. Should these be coded as uncertain behavior or unspecified? Answer: Uncertain behavior is a diagnosis that should only be assigned by a pathologist (with a path report)....
December 19, 2019 Question: Our coder sometimes uses measurements listed in the pathology report for lesion excisions, because the measurements are unclear or missing in the procedure note. Is this ok? Answer: No, for several reasons. Once removed, tissue(s) shrink so don’t depend on the measurements listed in the pathology report as it will most...
December 5, 2019 Question: How do we code for 2 separate incisional biopsies – one on the back and another on the patient’s lower lip? Do we use 11106 and 11107 or 11106 and 40490? Do we need any modifiers to make sure the claim is paid? Answer: If all are incisional biopsies (not tangential...
November 14, 2019 Question: What is the definition of simple vs complicated for the I&D codes 10060 versus 10061? Answer: While CPT doesn’t define the difference between “simple” and “complicated”, it is the accepted practice that a simple I&D 10060 is just that. An incision (not just a puncture) is performed, and the abscess is...
