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General Surgery Coding Alert

Reader Question:
Too Small for Intermediate Closure

Question: I'm aware of a "rule" regarding lesion excision and closure charges that I am quite sure I've seen in writing, but I can't find it in CPT®. The rule is that if the size of a lesion is 0.5 cm or less, we cannot also charge for an intermediate repair code. Is that true, and if so, where is it written?Ohio SubscriberAnswer: You aren't missing anything in CPT® -- Medicare's Correct Coding Initiative (CCI) holds the answer. CCI bundles the following lesion excision codes with their corresponding intermediate repair code as a column 2 code:11400 (Excision, other benign lesion including margins, except skin tag [unless listed elsewhere], trunk, arms, or legs; excised diameter 0.5 cm or less) with 12031 (Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities [excluding hands and feet]; 2.5 cm or less)11420 (Excision, benign lesion including margins, except skin tag [unless listed elsewhere], scalp, neck, hands, [...]


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