Forum - Questions & Answers

Jun 3rd, 2010 - jrussell2060 6 

Skin Tag Removal

We are trying to bill Caresource, a Medicaid HMO for procedures 11200 and 11420. We applied modifier 51 to 11200, which they have stated needs prior auth, which we are trying to get retro. However, code 11420 is stating it bundles? Can someone please clarify if 11420 bundles with code 11200? I do not have that CCI edit book.
Thank you

Jun 3rd, 2010 -

skin tags

It is not that these codes are bundled it is that your trying to double dip for payment. code 11420 specifically states except skin tags. Therefore if you are removing skin tags you can not bill this code.Code 11200 would cover the entire procedure if you are removing skin tags. If you are removing another type of benign lesion then you would use the 11420. Hope this helps!

Jun 8th, 2010 - mkizewski 2 

Skin Tag removal

If you did do both a skin tag removal and a benign lesion removal use a 59 modifier on the lesser code. Hope this helps.



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