CPT code 11641 is for the excision of malignant skin lesions on the face, ears, eyelids, nose, or lips, with margins, measuring 0.6 to 1.0 cm.
CPT code 11641 is used for the excision of malignant skin lesions, including margins, on the face, ears, eyelids, nose, or lips, with the lesion size ranging from 0.6 to 1.0 centimeters. This code is specific to procedures where the surgeon removes cancerous growths from these sensitive and cosmetically significant areas, ensuring that the margins around the lesion are also excised to reduce the risk of recurrence.
When using CPT code 11641, which pertains to the excision of malignant skin lesions, 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. This modifier is used 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 surgical session.
4. Modifier 58: Staged or related procedure or service by the same physician during the postoperative period. This modifier is used if the procedure was planned or anticipated at the time of the original procedure.
5. Modifier 59: Distinct procedural service. This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day.
6. Modifier 76: Repeat procedure or service by the same physician. Use this modifier if the same procedure was repeated by the same physician.
7. Modifier 77: Repeat procedure by another physician. This modifier is used if the same procedure was repeated by a different physician.
8. Modifier 78: Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period.
9. Modifier 79: Unrelated procedure or service by the same physician during the postoperative period. This modifier is used if the procedure is unrelated to the original procedure.
10. Modifier 90: Reference (outside) laboratory. Use this modifier if laboratory procedures were performed by a party other than the treating or reporting physician.
11. Modifier 91: Repeat clinical diagnostic laboratory test. This modifier is used if the same laboratory test was repeated on the same day to obtain subsequent (multiple) test results.
12. Modifier 95: Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system. Use this modifier if the service was provided through telemedicine.
13. Modifier LT: Left side. This modifier is used to indicate that the procedure was performed on the left side of the body.
14. Modifier RT: Right side. This modifier is used to indicate that the procedure was performed on the right side of the body.
15. Modifier XS: Separate structure. This modifier is used to indicate that a service was performed on a separate organ/structure.
16. Modifier XE: Separate encounter. This modifier is used to indicate that a service was performed during a separate encounter.
17. Modifier XP: Separate practitioner. This modifier is used to indicate that a service was performed by a different practitioner.
18. Modifier XU: Unusual non-overlapping service. This modifier is used to indicate that a service does not overlap usual components of the main service.
These modifiers help provide additional information about the procedure performed and ensure accurate billing and reimbursement. Always refer to the latest coding guidelines and payer-specific requirements when applying modifiers.
The CPT code 11641 is reimbursed by Medicare, but it is essential to verify the specific reimbursement details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides the payment rates for services and procedures covered by Medicare. Additionally, reimbursement can vary based on the local policies set by the Medicare Administrative Contractor (MAC) for your region. Therefore, it is advisable to consult the MPFS and your regional MAC to confirm the exact reimbursement rate and any specific billing requirements for CPT code 11641.
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