tci Medicare Compliance & Reimbursement - 2008 Issue 15

Part B Mythbuster: Dismantle This Common Wound Repair Myth

Know what 12001-13160 includes to get on the road to correct coding Myth: Wound repair codes include lesion excisions, and lesion excision reimbursement includes wound repair charges.Reality: Lesion excision codes can include wound repairs, but this rule is only a one-way street. You will often see healthcare providers perform wound repairs (12001-13160) alongside lesion excisions and debridement, but you won't always be able to code each procedure independently. In fact, you should never include excision of lesions, whether benign (11400-11471) or malignant (11600-11646), in wound repair. Lesion excision, however, may include wound repair, depending on the type of...

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