tci Medicare Compliance & Reimbursement - 2007 Issue 35

CODING: Are You Incorrectly Limiting Yourself To Superficial Excisions?

Get the facts to boost your excision reimbursementWhen your physician performs lesion excisions, don't forget that you may be able to access the musculoskeletal (20000-series) codes, or you could seriously undercut your reimbursement for these procedures. When you report an excision procedure, such as a lipoma (fatty tumor) removal, consider reporting either the codes for benign lesion excision (11400-11471) or the codes for musculoskeletal soft-tissue excision.Your code choice depends on the excision's depth and, just as important, the specificity of the physician's documentation, says Jeffrey Weinberg, MD, director of the Clinical Research Center, Department of Dermatology, at St...

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