tci Outpatient Facility Coding Alert - 2015 Issue 10

Reader Question: Shave Denials with Modifiers for Multiple Sites

Question: The physician shaved three epidermal lesions that the patient chose not to have submitted to pathology. The physician shaved a 0.4 cm lesion from the patient’s chest, a 0.3 lesion from the patient’s back, and a 0.2 lesion from the patient’s stomach. Will I need modifiers to report the shaves? Florida Subscriber Answer: Because CPT® classifies the shaves with the same anatomic area and size code, you will need a modifier on the second and third excision codes. Without the modifiers, the insurer’s software system may throw out the additional shaves...

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