CCSD code E0910 – Excision of lesion of external nose

Key takeaways

CCSD code E0910 is the UK private medical insurance code for excising a lesion from the outside of the nose.

Lesions inside the nose take a different code, such as E0820 for excision of lesion of internal nose.

E0910 stays the same for benign and malignant lesions, so the diagnosis on the claim carries the pathology.

Ask the patient’s insurer for an authorization number before the procedure, then record it on the claim.

Most claims reach the insurer through Healthcode, backed by an operative note that names the site, size and margins.

CCSD code E0910 covers lesions on the outside of the nose

CCSD code E0910 is the procedure code for excision of a lesion of the external nose. The official descriptor reads “Excision of lesion of external nose”. It sits in Chapter 5 of the CCSD schedule, Ear, nose and throat, under nose and nasal cavity.

The schedule is maintained by the Clinical Coding & Schedule Development (CCSD) Group. UK private medical insurers use its codes to identify the procedure on a claim. They include Bupa, AXA Health, Aviva, Vitality, WPA, Freedom and Allianz Care.

The code covers the skin and soft tissue of the external nasal surface. That includes the tip, ala, dorsum, sidewall and columella. Lesions of the nasal cavity, septum or turbinates fall outside it.

E0910 is a minor procedure, and Freedom Health Insurance bands it as Minor. ENT surgeons, plastic surgeons and dermatologists in private practice all bill it.

What the excision involves

Surgeons removing a lesion under E0910 follow a set sequence. Knowing the steps helps coders check that the operative note records each one.

1. Anesthesia: Local anesthetic infiltration is standard for small lesions. General anesthesia may suit extensive lesions, children or combined procedures, and the anesthetist bills for it separately.
2. Marking the margins: The surgeon marks a margin of normal-looking skin around the lesion. Malignant lesions usually need a wider margin, recorded in millimeters.
3. Excision: A scalpel removes the lesion with the planned margin of normal tissue around it.
4. Specimen handling: The specimen is oriented, often with a marking suture, and placed in formalin. It goes to histopathology, which the laboratory bills separately.
5. Closure: Small defects usually close directly with sutures. Larger defects may need a local flap or skin graft, which can carry its own CCSD code.
6. Dressing and follow-up: A sterile dressing goes on, and the note records aftercare and the suture removal date.

Each step has a documentation counterpart. A note that says only “lesion excised from nose” gives the insurer grounds to query the claim.

Benign or malignant: The diagnosis carries the pathology

The same code applies to a cyst on the nasal tip and to a basal cell carcinoma on the ala. The pathology shows up elsewhere: in the diagnosis code on the claim, the margin width and the detail in the note.

Insurers ask for the diagnosis alongside the procedure code. The UK uses the WHO edition of ICD-10, so codes are shorter than their US ICD-10-CM equivalents.

Use the most specific code the record supports. The WHO ICD-10 browser shows the full code hierarchy.

Neighboring nose codes and how to choose

Several nose codes sit near E0910 in Chapter 5. They get mixed up when the site or the operation differs from a simple external excision.

The most common mix-up is E0910 versus E0820. If the note names the nasal mucosa or the septum, E0910 does not apply. Skin lesions elsewhere on the face are coded from the skin chapter of the schedule instead.

A septal lesion that is only sampled takes E0330. Rebuilding the nasal framework after tumor removal takes E0230. Read the site in the operative note first, then the operation, as the path below shows.

For how one major insurer applies the wider schedule, see our guide to Bupa CCSD codes.

What bills alongside E0910

The CCSD schedule has no CPT-style modifiers. Instead, each code carries notes and a list of unacceptable combinations. Check the E0910 listing on the CCSD website before you add a second code to the claim.

• Histopathology: The laboratory bills tissue analysis under its own claim. It is not part of the surgeon’s E0910 fee.
• Flap or graft repair: Direct closure with sutures is part of the excision. A local flap or skin graft may carry its own code, subject to the insurer’s rules.
• Anesthesia: Local anesthetic given by the surgeon is part of E0910. An anesthetist who gives general anesthesia bills the insurer separately.
• More than one lesion: If you remove two lesions from the external nose in one session, ask the insurer how it wants them billed.

Documentation insurers expect for E0910

An operative note for E0910 should hold each item below. Insurers query claims whose note leaves one of them out.

• Anatomical site: The exact location on the external nose, such as “left nasal ala” or “nasal tip”.
• Lesion size: Dimensions in millimeters.
• Margins: Planned and achieved margins in millimeters, for benign and malignant lesions alike.
• Closure method: Direct closure, flap or graft, with the suture material used.
• Specimen: Confirmation that the specimen went to histopathology, with the request number where available.
• Consultant details: Name, professional registration, insurer provider number and the date of the procedure.
• Authorization: The insurer’s authorization number and the patient’s membership number.

Authorization and claim submission for E0910

Check cover and get authorization

Most UK private medical insurers expect the patient to get authorization before planned treatment. Rules differ between insurers such as Bupa, AXA Health, Aviva and Vitality, so check before the procedure date.

The patient often calls the insurer, but the practice needs these details on file:

• The CCSD code E0910 and its descriptor.
• The patient’s policy or membership number and the authorization number.
• The consultant’s name and insurer provider number.
• The clinical reason, plus the lesion’s site, size and suspected diagnosis.
• A provisional ICD-10 code.
• The planned date, the facility and the type of anesthesia.

Treating without authorization risks a declined claim, leaving the patient to pay. Most policies also exclude cosmetic treatment. Record the clinical reason for removal, such as bleeding, growth or suspected cancer.

How to submit an E0910 claim

Most UK practices send E0910 claims electronically through Healthcode, the UK’s private healthcare clearing house. The steps below follow a typical workflow in private practice claims software.

1. Open the encounter: Open the patient’s record for the date of service. Attach the operative note and the histology request.
2. Enter the procedure code: Select E0910 and confirm the descriptor matches the operation performed.
3. Add the diagnosis: Add the ICD-10 code, such as D23.3 or C44.3. If histology is pending, use the clinical diagnosis and flag the claim.
4. Check combinations: Confirm that no other code on the claim appears on E0910’s unacceptable combinations list.
5. Add the authorization: Enter the patient’s membership number and the insurer’s authorization number.
6. Review and submit: Check for missing fields, submit through Healthcode, and track the claim until the insurer pays.

Common reasons E0910 claims come back

Returned E0910 claims follow a few predictable patterns. Most are fixed at the coding and documentation stage, long before an appeal.

Fees for E0910

The CCSD Group sets codes and descriptors, not fees. Each insurer publishes its own fee or benefit limit for E0910. Freedom Health Insurance, for example, bands E0910 as Minor in its Freedom Elite schedule, effective October 1, 2026. It pays a specialist fee of £100 and an anesthetist fee of £194.

What the consultant receives depends on a few factors:

• Insurer and policy: Fees differ between insurers, and sometimes between policies from the same insurer.
• Complexity band: Many insurers group codes into bands such as Minor, Intermediate and Major. E0910 sits in a minor band.
• Facility costs: The hospital or day-case unit bills its own charges, separate from the consultant’s fee.
• Shortfalls: If the consultant charges more than the insurer pays, the patient may owe the difference. Tell the patient before the procedure.

Check current figures in each insurer’s provider tools, such as the Healix fee schedule and the Vitality fee finder. Then update your practice’s price list whenever an insurer revises its fees.

How Pabau keeps E0910 claims tied to the record

Nasal lesion claims often fail on admin. The note sits in one system, the invoice in another, and the authorization number in an inbox.

Pabau, the practice management and billing platform we build, holds all three on one patient record. Through its Healthcode integration, your team turns an insured patient’s invoice into an electronic claim. Claims are checked against Healthcode’s validation rules before they are sent.

Claim status is then tracked from the claims dashboard. The team can see which E0910 claims are still outstanding without logging into a separate portal.

For surgical practices, Pabau keeps consent forms and procedure notes with the claim. A nasal excision note template can prompt for site, size, margins and closure at the point of care.

Still comparing options? Our roundup of the best medical billing software in the UK shows how platforms handle private insurance claims.

Keep E0910 claims and operative notes together

Pabau keeps the operative note, invoice and authorization number on one patient record and submits CCSD-coded claims through Healthcode. Your team then tracks each claim until it is paid.

Book a demo

Conclusion

E0910 is one of the simpler nose codes to apply, because the site decides it. A lesion on the outside skin takes E0910, and one inside the nose takes another code.

When an E0910 claim comes back, the paperwork is usually to blame. A vague operative note, a missing authorization number or an intranasal diagnosis will send it back. Fix those three before the claim leaves the practice, and E0910 rarely needs a second look.

If your team still chases notes and authorization numbers across systems, start there. Book a demo to see how Pabau keeps ENT claims and records together.

Continue your research

Treating recurrent nosebleeds? CCSD code E0380 explains how to code nasal septum cauterization.

New to CCSD coding? CCSD codes explained covers how the schedule is built and maintained.

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