CPT code 11303 is for the shaving of a skin lesion larger than 2.0 cm. It helps in billing and documentation for healthcare services.
CPT code 11303 is used to describe the procedure of shaving a skin lesion that is larger than 2.0 centimeters. This code is specifically for instances where a healthcare provider removes a lesion by shaving it off the surface of the skin, rather than cutting it out entirely. This method is typically used for lesions that are raised above the skin surface and is often performed to diagnose or treat skin conditions.
For CPT code 11303, which pertains to the shaving of a skin lesion greater than 2.0 cm, the following modifiers may be applicable:
1. Modifier 25: Significant, separately identifiable evaluation and management (E/M) service by the same physician on the same day of the procedure or other service. Use this modifier if an E/M service was provided in addition to the procedure.
2. Modifier 50: Bilateral procedure. Use this modifier if the procedure was performed on both sides of the body.
3. Modifier 51: Multiple procedures. Use this modifier if multiple procedures were performed during the same session.
4. Modifier 59: Distinct procedural service. Use this modifier to indicate that the procedure was distinct or independent from other services performed on the same day.
5. Modifier 76: Repeat procedure or service by the same physician. Use this modifier if the procedure was repeated by the same physician on the same day.
6. Modifier 77: Repeat procedure by another physician. Use this modifier if the procedure was repeated by a different physician on the same day.
7. Modifier 78: Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period. Use this modifier if the patient had to return to the operating room for a related procedure.
8. Modifier 79: Unrelated procedure or service by the same physician during the postoperative period. Use this modifier if an unrelated procedure was performed during the postoperative period of the initial procedure.
9. Modifier 90: Reference (outside) laboratory. Use this modifier if laboratory procedures were performed by a party other than the treating or reporting physician.
10. Modifier 91: Repeat clinical diagnostic laboratory test. Use this modifier if a clinical diagnostic laboratory test was repeated on the same day to obtain subsequent (multiple) test results.
11. Modifier LT: Left side. Use this modifier if the procedure was performed on the left side of the body.
12. Modifier RT: Right side. Use this modifier if the procedure was performed on the right side of the body.
These modifiers help provide additional information about the procedure performed and ensure accurate billing and reimbursement.
CPT code 11303, which involves the shaving of a skin lesion greater than 2.0 cm, is reimbursed by Medicare. The reimbursement is determined based on the Medicare Physician Fee Schedule (MPFS), which outlines the payment rates for services provided to Medicare beneficiaries.
Additionally, the specific reimbursement amount can vary depending on the region, as it is subject to adjustments by the local Medicare Administrative Contractor (MAC). Therefore, healthcare providers should consult the MPFS and their respective MAC for precise reimbursement details for CPT code 11303.
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