How to submit removal of fibroma on lip to medical

[Jeremy Hobbs]

Looking to get a good idea of codes

[niermanpm]

Hi Jenny! Hm that is interesting, i do show that 40810-40816 are currently active/valid CPT codes…. 40812 stands for: Excision of lesion of mucosa and submucosa, vestibule of mouth; with simple repair 4110-41114 are as follows: 41110 – Excision of lesion of tongue without closure 41112 – Excision of lesion of tongue with closure; anterior two-thirds 41113 – Excision of lesion of tongue with closure; posterior one-third 41114 – Excision of lesion of tongue with closure; with local tongue flap For biopsy of the lip or excision of lesion of the lip, you may consider: 40490 – Biopsy of lip 11440 – Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.5 cm or less 11441 – Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.6 to 1.0 cm 11442 – Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 1.1 to 2.0 cm 11443 – Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 2.1 to 3.0 cm 11444 – Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 3.1 to 4.0 cm 11446 – Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter over 4.0 cm Hope this helps!

[niermanpm]

I submitted a medical claim for this exact situation, however the insurance told me that these codes 40810-40816 are no longer used and I should use 41110-41114. I”m confused as they are different procedures and descriptions. We in fact did a 40812 but insurance will not pay this. Is there a more appropriate code for excisional biopsy of lesion on lower right lip (Irritation Fibroma, Lipoma)? Thank you for your insight!

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