Author Topic: 11100 (skin tag) and 11200 (lesion) together  (Read 1283 times)

arvsun

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11100 (skin tag) and 11200 (lesion) together
« on: May 04, 2015, 11:47:21 PM »
Hi

We performed both of these on the patient. however the claim inspector is telling us to put modifier. The usual net articles say to add 59 to 11100 since that iower rvu claim, but that is not helpng

Thanks for your expert contents

arv

Rclausing

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Re: 11100 (skin tag) and 11200 (lesion) together
« Reply #1 on: May 09, 2015, 05:51:27 PM »
AFAIK the 59 modifier should be added to the higher RVU CPT, as the ones with the 51 modifier (if used, or the ones without modifiers if not) would be the ones that get paid under the multiple procedure rule.

EDIT:
The title on your post just clicked: CPT 11100 is for reporting a skin biopsy, not the removal of skin tags, which would be 11200. The destruction of actinic keratosis should be reported using code 17000/17003/17004, and ALL other benign skin lesion destructions (warts, SK's etc) are reported with 17110/17111. So, if you destroy several different types of benign lesions at the same visit (or within the 10 day post op period) you only bill 17110 or 17111 based on the total number of lesions. It may also be the diagnosis code you are using to bill for skin tag removal. Many insurance companies will not pay for these codes, considering them to be cosmetic, unless billed with a secondary dx code like V49.89 - note that the physician note MUST indicate pain, bleeding, inflamed etc. Irritated is not sufficient to indicate the use of V49.89.
« Last Edit: May 09, 2015, 06:40:42 PM by Rclausing »