Shade Posted Wed 10th of December, 2014 21:33:16 PM
PT WAS SEEN FOR A SHAVING OF EPIDERMAL OF FACIAL BASAL CELL CARCINOMA. CPT CODE 11312 WITH DX CODE 173.31 AND INSURANCE DENIAL WITH DX NOT CORRECT WITH THE PROCEDURE CODE. PLEASE HELP WITH DETAIL EXPLANATION. THANK YOU.
SuperCoder Answered Thu 11th of December, 2014 06:25:50 AM
A provider usually removes a lesion by shaving that he suspects is benign. Typically, a basal cell carcinoma is a malignant lesion that is removed by excision for which there is an appropriate range of procedure codes.
I believe your provider must have shaved the lesion when exact nature of lesion was not known. And it is only after pathological examination following shave removal, the malignant lesion of nature was confirmed.
If above statement is correct, then you should use ICD code 238.2, Neoplasm of uncertain behavior of skin.
Shade Posted Thu 11th of December, 2014 10:36:22 AM
SuperCoder Answered Thu 11th of December, 2014 12:11:51 PM