Dermatologists are the only providers that use the codes in the Integumentary System subsection of the CPT (T/F)
The Integumentary subsection is formatted how in the CPT?
Basis of anatomic site and category of procedure
I&D (incision and drainage) codes are divided how?
According to condition & then according to whether the procedure is simple or complicated/multiple.
Cleaning of an area or wound. Some surgical procedure codes include debridement as part of the service. If the medical record indicates that a greater than usual debridement was done then this may be reported separately.
Types of lesion treatments
Paring (peeling or scraping), shaving (slicing), excision (cutting removal), and destruction (ablation)
To code lesion treatment, what information must you know?
The site, number and size of the excised lesions as well as whether the lesion was malignant or benign (billing cannot be submitted until the pathology report has been completed). Does not apply to destruction of lesion since is not sent to pathology, refer to physician notes.
How do you code the treatment of multiple lesions?
Code the most complex procedure first (without modifier) and the others using modifier -51. If the code description includes multiple lesions (stated number), then the -51 is not necessary.
What items are included in the codes for lesion excision?
Direct, primary, or simple closure of the operative site. Any closure other than a simple closure can be reported separately.
Does the shaving (does not penetrate through the dermis) of lesions require a closure?
No-no incision has been made. Anesthesia and cauterization (electrocautery or chemical cautery) to control bleeding are included in the lesion-shaving codes. Codes are defined by location of the lesion and size of the lesion. If multiple removed, add modifier -51 to any code after the 1st, always placing the most intensive (largest lesion) first.
Types of destruction
Freezing, burning, chemicals, etc.
Paring or Cutting codes are used to report what?
Include removal by peeling or scraping and bleeding is usually controlled by a chemical applied to the surface.
Should not report both a biopsy removal and an excision as the biopsy is bundled into the excision service. Modifier -51 is not used with these codes. Base code is used to report the first and add on code is used to report additional biopsied lesions. 11100, 11011x2 (three lesions)
Skin tag codes
Benign lesions, most often found of face or trunk. Simple closure is included in the skin tag codes as is any local anesthesia that is used. Codes are based on # of lesions removed. Modifier -51 is not used with these codes.
The codes in the excision of benign lesions are used for all benign lesions except _______.
Skin tags (these codes include local anesthesia and simple closure). If closer is intermediate or complex you would code using a separate code from Repair subheading.
Difference between shaving and excision
Shaving does not penetrate the dermis (full thickness), excision does. Full thickness shavings are reported using excision codes.
When coding excision of benign or malignant tissue, what information determines selecting the correct CPT code?
Normal tissue margin (lesion plus the surrounding tissue excised)
Debridement of nails includes supplies which are not reported separately (T/F)
Difference in recipient site and donor site in skin grafting
Recipient site is the area of defect that receives the graft. Donor site is the area from which the healthy skin has been taken for grafting.