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Cynthia Posted Sat 25th of November, 2017 12:45:43 PM
The doc did did the following procedures on the same day 99213 11403 11423 x4 12035 Dx Ro3.0. L72.3 Please. I get so confused with multiple procedures for the correct modifiers Adding up the excisions puts the repair over 12.6 cm. This is the dr office.
SuperCoder Answered Mon 27th of November, 2017 00:29:41 AM

Hi,

 

For modifiers while billing multiple units of 11423, 

Some payers prefer: 11423 Excision lesion 1; 11423-51 Excision lesion 2; 11423-51 Excision lesion 3, so on.

Some payers prefer: 11423 Excision lesion 1; 11423-59 Excision lesion 2; 11423-59 Excision lesion 3, so on.
Others including medicare intermediaries want: 11423 Excision lesion 1; 11423-59,51 Excision lesion 2; 11423-59,51 Excision lesion 3, so on.

So, it is payer specific. Contact your local payer for its policy details regarding this.

 

E/M codes are not seperetely reported with excision codes. You can try to bill 99213-25 with R03.0 if it gets paid. 

 

Hope that helps!

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