Forum - Questions & Answers

Apr 12th, 2018 - sharris

Repairs after lesion removal Under 1cm and .5cm and under

Many times provider is indicating intermediate repair or complex repair for under 1cm. In the CPT book under complex repair it indicates "for 1.0cm or less, see simple or intermediate repair".

So in the scenario of lesion removal the provider indicates 1.0 cm for intermediate repair after lesion removal I am taking this that since the next one down is simple we would not bill a repair?

There is nothing in the CPT book that indicates repairs of .5cm and less during lesion removal. I would think that intermediate or complex of .5cm is not billable? Am I correct in this thinking?

Thank You very much

May 23rd, 2018 - MargeM   11 

re: Repairs after lesion removal Under 1cm and .5cm and under

You are correct that repair under .5cm is not billable because those usually are a simple repair and thus part of the procedure.

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