If a dermatologist performs an excision (11400) with benign lesion destruction (17110), both codes are reportable and a modifier will be necessary to “bypass” the edit. If a claim is filed, ICD-9 CM code V50.1 (Other plastic surgery for unacceptable cosmetic appearance) should be used in conjunction with the appropriate procedure code
CPT CODE SOFT TISSUE HEAD AND NECK SKIN
Procedure codes 11400-11446 should be used when the excision is a full-thickness (through the dermis) removal of a lesion, including margins, and includes simple (non-layered) closure.Ĭlaims for removal of benign skin lesions performed merely for cosmetic reasons may not necessarily need to be submitted to Medicare unless the patient requests that a formal Medicare denial is issued.
11400- Excision, benign lesion, except skin tag (unless listed elsewhere), trunk, arms or legs lesion diameter 0.5 cm or less – average fee payment – $130 – $140ġ1401 Excision, benign lesion, except skin tag (unless listed elsewhere), trunk, arms or legs lesion diameter 0.6 to 1.0 cmġ1402– Excision, benign lesion, except skin tag (unless listed elsewhere), trunk, arms or legs lesion diameter 1.1 to 2.0 cmġ1403 Excision, benign lesion, except skin tag (unless listed elsewhere), trunk, arms or legs lesion diameter 2.1 to 3.0 cmġ1404 Excision, benign lesion, except skin tag (unless listed elsewhere), trunk, arms or legs lesion diameter 3.1 to 4.0 cmġ1406 xcision, benign lesion, except skin tag (unless listed elsewhere), trunk, arms or legs lesion diameter over 4.0 cm
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