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Ask a Rev Cycle Expert: Coding a Lesion Excision?

Question:

I am having issues coding a lesion excision case. Both lesions were on the neck. The right-sided lesion was 1.5 cm and the other left-sided lesion was 1.4 cm. How would I report these?

Answer:

Current Procedural Terminology (CPT®) guidance states a code is reported for each lesion. Report CPT® code 11422 Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm for each lesion as the 1.4 cm and 1.5 cm fall within the 1.1 to 2.0 cm range listed within the CPT® description. CPT® guidance indicates modifier 59 Distinct Procedural Service to be appropriate.

Disclaimer: This information was current at the time of its publishing and is designed to provide accurate information in regard to the subject matter covered. Vitalware does not accept any responsibility or liability with regard to any errors, omissions, misuses, or misinterpretation by the reader. It is not intended to take the place of either the written policies or regulations. We encourage you to review the specific regulations and other interpretive materials as necessary. All CPT® codes are trademarked by the American Medical Association (AMA) and all revenue codes are copyrighted by the American Hospital Association (AHA).