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Chemical cauterization for umbilical granuloma

Since the changes in the CPT 17250 (last update) we have been getting denials from many of the insurance companies. Newborn comes in for first office visit with provider and we us to be able to charge an office visit 992XX with a 25 and the 17250 for chemical cauterization of the umbilical granuloma However since the update they are bundling the 17250 even when we use the modifier 25 with a E/M code. At first I thought that it was because of the update in the icd 10 codes. Since the P83.8 Other specified conditions of integument specific to newborn was what the providers used. However, when I added the 5th digit P83.81 Umbilical granuloma. The insurances are still bundling or denying. My scrubbers don’t come up with any NCCI edits. Any suggestions for getting it paid or resources to go to definitively say it should be bundled?

Medical Billing and Coding Forum

Lesion Cauterization

I need help finding a CPT code for this procedure. I wanted to use 11421, but the cauterization is making me question it:

1 cm verrucous lesion at the right labial perineal border
*
Recommend excision/cauterization patient agreeable
*
Sterile prep and drape, 2% lidocaine injection at the base of the lesion,
Cauterization using portable disposable cautery of the lesion with 15 blade debridement and cauterization of the base was accomplished. The patient tolerated the procedure well.
Return visit for evaluation as needed

Any advice? Thanks!

Medical Billing and Coding Forum