Forum - Questions & Answers

Nov 22nd, 2016 - npott1 9 

Punch excision?

Patient had Mohs surgery on ear healing by second intention, 1st post op visit 14 days later the physician did 4 punch excisions (?) 0.2 cm each to Mohs site to facilitate healing. How would you code this? Are they considered excisions? If so, would 11400 x 1, 11400 with modifier 76 on each to follow be correct? The physician coded it as 11643 x 4, but the patient had Mohs and the site was cleared of malignancy............ Any help appreciated.

Nov 29th, 2016 - npott1 9 

re: Punch excision?

Really? Nobody? Ideas?

Nov 29th, 2016 - lisakay1957 11 

re: Punch excision?

Per your notes the code that you are using would be incorrect as per CPT® 11400 is for excision of benign lesions of the trunk, arms or legs. the correct code to use per CPT® would be 11440, excision of benign lesions face ,ears eyelids, nose, lips and mucous membranes.

The code that your provider is using is also incorrect. Per CPT® 11643 is for excision of malignant lesions and per your note the patient was cleared of malignancy.

I would use code 11440 and I would not add a modifier 76 as that is for repeat procedure or service by the same physician. If the provider did a mohs procedure 117311-17312, then you are not repeating the same procedure. I would add a modifier 58, staged or related procedure or service the same physician or other qualified health care professional during the global period. I did look up 117311 on the MCR website and per the site this procedure does not have a global period though. I would bill this as 11440x4, hope this helps:)

Nov 29th, 2016 - npott1 9 

re: Punch excision?

Thanks for your help! Appreciate it.

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