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separate cpt codes for a malignant skin excision...

Robert Posted Tue 19th of June, 2012 04:43:20 AM

and "Repair" (double layer). I do quite a bit of office-based dermal surgery; mostly basal cell CA, or S.Q. cysts which I can treat and can be quite large to remove and repair. IE. Patient had a 7 x 5 basal cell CA above his left breast. Received local anesthesia and lesion was excised with 2mm margin between excision and neoplasm. Can I bill two cpt codes, one defined by Excision CPT codes (ie. length, depth, location), and with a widely open wound requiring a double layer closure, bill for the repair, which requires, of course more time, suture technique and two suture packs, I'm sure which is bundled under "Repair." After 30 years in practice, I've never charged for a repair (closure) in addition to the Excision defined cpt code. Have I've been naive over doing hundreds of office surgeries, which would otherwise, have probably landed in an O.P. wound care of plastic surgeon's authority with an insurance company paying multiples of what I charge in a non-facility? Thanks. Dr. Bader.

SuperCoder Answered Tue 19th of June, 2012 17:59:20 PM

Obviously,the scenario you have mentioned requires both excision as well as repair codes. Layered closures are always reported along with the excision codes.

Intermediate repair includes the repair of wounds that, in addition to the above, require layered closure of one or more of the deeper layers of subcutaneous tissue and superficial (non-muscle) fascia, in addition to the skin (epidermal and dermal) closure. Single-layer closure of heavily contaminated wounds that have required extensive cleaning or removal of particulate matter also constitutes intermediate repair.

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