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lesion removal/complex repair

Francisco Posted Tue 27th of November, 2012 20:29:33 PM

outpatient surgery to remove lip lesion '40510' with complex repair. I used '13131' for the complex closure of the lip. Medicare paid for '40510', but denied '13131' saying it is not covered when performed during same session/date as primary procedure '40510'. Do I need a modifier on '13131', or is there a better code for complex repair of the lip (1cm lesion)?

SuperCoder Answered Wed 28th of November, 2012 03:38:39 AM

Yes, use Modifier 59 with 13131 to distinguish it with 40510.

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