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Forum Discussion Areas > Ask Us a Question > What modifier would be used with excision of a 2.5 malignant lip lesion and two malignant lesions of the chest, each 1.5 cm in diameter?
  What modifier would be used with excision of a 2.5 malignant lip lesion and two malignant lesions of the chest, each 1.5 cm in diameter?
LaurenM
What modifier would be used with excision of a 2.5 malignant lip lesion and two malignant lesions of the chest, each 1.5 cm in diameter?
Posted:
Apr 16 2011, 12:38 AM

 
ca4664
re: What modifier would be used with excision of a 2.5 malignant lip lesion and two malignant lesions of the chest, each 1.5 cm in diameter?
Posted:
Oct 25 2011, 6:40 PM
What modifer would be used wiyh excsion ofa2.5 malignant lip lesion

 
smaynard
re: What modifier would be used with excision of a 2.5 malignant lip lesion and two malignant lesions of the chest, each 1.5 cm in diameter?
Posted:
Oct 26 2011, 9:32 AM
I would say none, there are no bundling issues.

 
gia
re: What modifier would be used with excision of a 2.5 malignant lip lesion and two malignant lesions of the chest, each 1.5 cm in diameter?
Posted:
Oct 26 2011, 10:42 AM
Don't forget to add together the two chest defects since the code will be the same.

 
Codapedia Editor
re: What modifier would be used with excision of a 2.5 malignant lip lesion and two malignant lesions of the chest, each 1.5 cm in diameter?
Posted:
Oct 27 2011, 2:48 PM
First, make sure your measurements are correct. A 2.5 cm lesion of the lip is about an inch long. Do you mean .25 cm?

Of course, you need to wait for the Path report before submitting.

Lesion excisions are the measurement of the excision, not the lesion.

The lesion removal codes are not added together, the way the repair codes are, when submitting a claim. If you remove three lesions, you code for all three separately.

The code for the excision of a malignant 2.5 cm on the lip is 11643. If the lesion was really .25 cm, the code is 11640.

For the chest lesion, a 1.5 cm lesion is 11602.

There are no NCCI edits for these codes.

Bill the code with the highest RVUs with no modifier.

Bill the second code with modifier 51, or no modifier.

If you are using the same code twice (two malignant codes of the same size, same location) you will need modifier 59 on the second.

Key points about lesion removal: Wait for the path report Check your measurements (2.5 cm on the lip is big! are you sure about the size?) Don't add together lesion sizes Use the size of the excision

READ the editorial comments in front of the lesion excision section in the CPT® book before you proceed.

 

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