Question

Instructions: Review the results generated by CAC software. Compare documentation in the case to the list...

Instructions:

  1. Review the results generated by CAC software.
  2. Compare documentation in the case to the list of possible diagnosis, procedure, and service codes generated by CAC software.
  3. Select codes that are supported by documentation in the case (from the list of possible codes generated by CAC software).

Case:

Patient was registered for ambulatory surgery due to skin lesion, left check. Patient underwent Excision of 4-cm malignant lesion, skin of left cheek. Discharge diagnosis was carcinoma in situ of the skin, left cheek.

Permission to reprint granted by Optum360®.



Which CPT code is reported for the first-listed procedure?

a. 11642
b. 11644
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Answer #1

PROCEDURE : EXCISION OF 4 CM MALIGNANT LESION OF THE SKIN IN THE LEFT CHEEK.BOTH CPT CODES REFER TO THE PROCEDURE BUT THE CORRECT ONE FOR THIS PROCEDURE IS 11644.BECAUSE CPT CODE OF 11642 IS FOR EXCISION OF MALIGNANT LESION WHICH IS AROUND 1.1 TO 2.0 CM IN DIAMETER BUT IF IT IS FROM 3.1 TO 4 CM ,THE CODE 11644 IS MENTIONED.IT IS A RELATED DIAGNOSITIC PROCEDURE .THE CODE ALSO CAN BE REFERRED TO THE EXCISION OF THE MALIGNANT LESION AROUND THE MARGINS, FACE,EARS,EYELIDS, NOSE AND LIPS.

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