multiple lipomas

I have a patient with multiple lipomas (5 on each forearm, 2 on the back, 2 on the abdomen). Each would require a separate incision to excise and each is greater than 3 cm. How would I code this (25071?). Bilateral modifier? or multiple units? I will also likely have to do intermediate repair. Any thoughts? Thanks in advance.

multiple lipomas

There are two issues to consider: the correct codes and the modifiers.

You would code for each excision, and if that particular excision required repair, for that as well. According to the multiple payment rules, you are paid 100% for the first, 50% for the 2nd--5th. After that, the payer will look at the note and decide. Who knows what they'll say?

If you are removing two soft tissue tumors from the same location (arm) and would need to use the same code twice --25071--you'll need a 59 modifier on the second code, to let the payer know it isn't a duplicate it was a separate lesion.

The abdomen soft tissue excisions are 22900--22903, depending on depth and size.

the back soft tissue excisions are 21930--21933.

Here's the process for coding:

List all of the procedures you've done, individually.
Check the RVUs. The one with the highest is billed first.
Check bundling. Since these are separate excisions, you will need a 59 modifier on the second bundled procedure in each group. If only one on the back, you wouldn't need a modifier on it.