Billing and Coding: Removal of Benign Skin Lesions
A57482
Coding must use the CPT that best describes the procedure, location, and lesion size, and diagnosis codes must match the CPT (benign CPTs must not be billed with malignant diagnoses). Use CPT 11200/11201 for skin tags, CPT 17110 for up to 14 non–skin-tag nonvascular benign lesions, CPT 17111 for 15+ such lesions, and CPT 11400-11446 for full-thickness excisions; observe unit-reporting rules and NCCI guidance. Cosmetic removals are noncovered (patient liable) and, if submitted at the patient's request, must be billed with modifier GY and diagnosis Z41.1; same-day E&M payment requires a documented, significant, separately identifiable service and modifier -25 while routine pre/post-op E&M and decision-to-treat visits are not payable and modifier -57 is not appropriate.
"Use CPT 11400-11446 when the excision is a full-thickness removal through the dermis including margins and including simple (non-layered) closure."