AHA Coding Clinic® for HCPCS - 2020 Issue 2; Ask the Editor

Breast vs. skin CPT codes

A patient with breast skin thickening presented for a punch biopsy of the right breast. A 3 mm punch biopsy was performed to remove the skin. After passing off the specimen, the wound was irrigated and dressed. When a biopsy is performed on the skin of the breast, is an integumentary CPT code or a breast code assigned? What is the determining factor in selecting a specific breast CPT code (code range 19000-19499) over a code from the more general “Skin, Subcutaneous, and Accessory Structures” section? ...

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