Digit Removal Medical Billing Questions

Just when you got a handle of medical billing, another policy throws a curve ball at you. In some instances, the same CPT code is used for two different procedures. An example of this is when performing both and extra digit removal and a skin tag removal. The same medical billing CPT code, 11200, would be used in both of these instances.

The medical billing code 11200 means, removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions. This means that if an individual needs an extra digit AND a skin tag removed, than you would use 11200 to report both.

To let the payers know the reasons, you would report two separate medical billing ICD-9 codes. For instance, you could use 757-759 (congenital anomalies), for the extra digit. Then you would use a medical billing code such as 757.39 (other specified anomalies of skin) to report the skin tags. This way, the payer will know that there were two different procedures performed.

One thing to keep in mind when doing medical billing for 11200, is that it can only be billed once per instance. The code actually describes removal of up to 15 different lesions during the same session. This is why it is so important to report the correct diagnosis codes when doing medical billing. They payer will have no idea how many lesions your remove if the codes are not reported.

Make sure all your staff are aware of the correct medical billing policies that could affect your practice. If you are a radiology facility, make sure you staff are up to date on all radiological procedures. Although it would be difficult to keep current with all medical billing policies, staying as current as possible is extremely beneficial.

View all Articles by: Melissa Clark, CCS-P