Most payers will not cover cosmetic scar revisions, so you should make sure the dermatologist establishes medical necessity for the procedure.
In many cases, patients with function-impeding scars present with scars around their eyes or mouth. For example, a patient with a basal cell carcinoma on the lip may have the dermatologist remove the carcinoma. The scar that forms as a result of that excision impedes the patient’s speech and eating, and therefore the dermatologist decides that the removal is medically necessary.
The dermatologist removes the scar, which is two centimeters long. You should report the procedure based on the location of the carcinoma that the dermatologist removed and the size of the excision. Measure each excision at the widest diameter, including any margins. So you would report 11442 (Excision, other benign lesion including margins, except skin tag [unless listed elsewhere], face, ears, eyelids, nose, lips, mucous membrane; excised diameter 1.1 to 2.0 cm), coding experts say.
In the situation above, the scar revision is cosmetic but the revision is part of the aftercare process.
Attending audio conferences about the hottest dermatology topics like this can do more than simply ensure your coding accuracy and decrease denials — it can safeguard your payments. In this tough economy, every dollar counts. Get real-life solutions to your toughest coding challenges with dermatology audio conferences.
You’ll find such conference topics as:
Bottom line: You don't have time to weed through the never-ending onslaught of information about dermatology coding and coverage, so let us do it for you.
I recently received 4 DVDs from Audioeducator; not only were they user friendly and portable; they contained invaluable information that I was able to...
Tara Rose Conte
AudioEducator is a useful, effective & efficient way to get updated on important coding issues that we face on a daily basis. The knowledge I gain...
Virginia Graziani Lowe, MD, JD
Thank you so much for your assistance during this complicated time of transition from ICD 9 to ICD 10. I have also found your webinars on the Medicare...
Greg Badger, RN, ADON, RAC-CT
Assistanted Director Of Nursing
The accessibility for registration &participation with the AudioEducator website was simple, direct & clear. I also found it quite helpful to ...
Nemours Center for Cancer & Blood Disorders