Don't have a TCI SuperCoder account yet? Become a Member >>

Orthopedic Coding Alert

Polydactyl Thumb Removal

Question: Our hand surgeon performed a polydactyl removal of right and left thumbs (no bone). CPT advises using 11200* (Removal of skin tags, multiple fibrocuta-neous tags, any area; up to and including 15 lesions). Should we code this just once, or twice with modifier -59 (Distinct procedural service) appended to the second unit? California Subscriber Answer: Because 11200 refers to "multiple fibrocuta-neous tags" and specifies that it covers up to 15 lesions, you should not bill additional units for the right and left sides, nor should you bill modifier -59 or modifier -50 (Bilateral procedure).

As a rule, if the code descriptor contains the word "multiple," such modifiers are inappropriate and unnecessary. In this case, 11200 should be reported only once with no modifiers.  

Other Articles in this issue of

Orthopedic Coding Alert

View All