CPT code 11644 is for the excision of malignant skin lesions on the face, ears, eyelids, nose, or lips, measuring 3.1 to 4 cm, including margins.
CPT code 11644 is used for the excision of malignant skin lesions, including margins, on the face, ears, eyelids, nose, or lips, with a lesion diameter of 3.1 to 4.0 centimeters. This code is specific to procedures where the surgeon removes cancerous skin tissue from these sensitive areas, ensuring that the excision includes a margin of healthy tissue around the lesion to help ensure complete removal.
For CPT code 11644, the following modifiers may be applicable:
1. Modifier 22 (Increased Procedural Services): Used when the work required to provide a service is substantially greater than typically required. This could be due to complications or unusual circumstances.
2. Modifier 25 (Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service): Applied when a significant, separately identifiable E/M service is performed by the same physician on the same day as the procedure.
3. Modifier 50 (Bilateral Procedure): Used when the procedure is performed on both sides of the body.
4. Modifier 51 (Multiple Procedures): Applied when multiple procedures are performed during the same session by the same provider.
5. Modifier 59 (Distinct Procedural Service): 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 Same Physician or Other Qualified Health Care Professional): Used when a procedure or service is repeated by the same provider.
7. Modifier 77 (Repeat Procedure by Another Physician or Other Qualified Health Care Professional): Applied when a procedure or service is repeated by a different provider.
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): Used when a patient returns to the operating room for a related procedure during the postoperative period.
9. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): Applied when an unrelated procedure or service is performed by the same physician during the postoperative period.
10. Modifier 80 (Assistant Surgeon): Used when an assistant surgeon is required during the procedure.
11. Modifier 81 (Minimum Assistant Surgeon): Applied when a minimum assistant surgeon is required.
12. Modifier 82 (Assistant Surgeon (when qualified resident surgeon not available)): Used when an assistant surgeon is required and a qualified resident surgeon is not available.
13. Modifier 91 (Repeat Clinical Diagnostic Laboratory Test): Applied when a clinical diagnostic laboratory test is repeated.
14. Modifier 99 (Multiple Modifiers): Used when multiple modifiers are necessary to describe the service provided.
Each of these modifiers serves a specific purpose and should be used according to the guidelines to ensure accurate billing and reimbursement.
The CPT code 11644 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 covered by Medicare and can be accessed online for the most current information.
Additionally, reimbursement can vary based on the region, as Medicare Administrative Contractors (MACs) may have specific guidelines and rates. Therefore, it is advisable to consult the relevant MAC for your area to ensure accurate and up-to-date reimbursement information for CPT code 11644.
Discover the power of MD Clarity's RevFind software to ensure you're receiving every dollar you're owed. With the ability to read your contracts and detect underpayments down to the CPT code level, including specific codes like 11644, RevFind provides unparalleled accuracy by individual payer. Schedule a demo today to see how RevFind can optimize your revenue cycle and protect your bottom line.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
