NCCI Edits HELP!

[Billing426]

I was hoping someone could help clarify the PTP Edits. From what I understand is if there are two codes listed together one in Column 1 and the other in Column 2 then they can't be reported together unless there is a significant reason for this, which then you would add a modifier 59 (X-EPSU).  I have a lesion excision code of 11400 (column 1) and a repair performed on the same lesion 12031 (Column 2). How do I determine if this is okay to put a modifier on the 12031 (Column 2)?

[Michele]

Are you a certified coder?  Do you have access to the patient's chart?  The only way to know is if you have access to the notes from the procedure. 

I am not a certified coder bur from what I understand lesions with excised diameter of 0.5 cm or less include simple, intermediate or complex repairs and they are not reported separately.  So unless there was an unusual circumstance that required a repair that is not included with the excision it wouldn't warrant the 12031.