Excision of Skin Lesion

August 4, 2016

I heard you say at a course (you were great, by the way. I learned a lot from you!) that we should wait for a pathology report before billing for excision of skin lesions. Please explain why. This may be why I’m not getting paid.

Thank you for your kind words, you made my day! Yes, you’ll need to wait for a pathology report when reporting the excision of skin lesion codes because the CPT code descriptions require the pathology be known. The codes are for removal of benign (114xx) and malignant (116xx) lesions. If you have a previous pathology report showing a malignancy (e.g., biopsy) then you can go ahead and bill the service using the malignant lesion excision code (116xx) without waiting for the pathology report.

*This response is based on the best information available as of 08/04/16.

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