Billing and Coding: Excision of Malignant Skin Lesions

This billing and coding guidance aligns excision coding to the manner of removal: use CPT 11600-11646 for malignant or high-suspicion lesions removed with moderate-to-wide margins and CPT 11400-11446 for benign or low-suspicion lesions removed with minimal margins. Coverage and frequency are governed by LCD L33818 and applicable CMS policies; complete, legible documentation (including lesion size/location, operative note, pathology report, and support for the ICD-10-CM code) is required and non-covered services must be reported with the appropriate modifier.

"Excision of malignant or clinically ambiguous lesions with moderate-to-high suspicion that require moderate-to-wide grossly normal skin/soft-tissue margins should be coded using excision of maligna..."

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