Medicare Compliance & Reimbursement - 2009 Issue 5
Reader Questions: Avoid Losing $20 Per Excision
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Article Overview
This article addresses a reader question about excision coding for lesions removed from the back and neck. It explains the relationship between pathology reports, operative documentation, lesion size measurement, and CPT excision code selection, with emphasis on why the physician’s record is needed for sizing and how pathology supports the final benign-versus-malignant category. The piece is aimed at coders and billing staff who work with skin lesion excisions and want to avoid undercoding due to incomplete documentation.
Why This Topic Matters
Accurate excision coding depends on documentation that reflects the procedure as performed, not just the specimen received by pathology. The article highlights how incomplete size documentation can affect code selection and reimbursement.
What You Will Learn
- How pathology reports relate to excision coding
- Why operative documentation matters for lesion size reporting
- How benign versus malignant categories are supported by pathology
- How incomplete documentation can affect reimbursement
Who Should Read This
- Medical coders
- Coding auditors
- Billing staff
- Compliance staff
- Physician practice coders
Codes Discussed
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