tci ED Coding & Reimbursement Alert - 2008 Issue 2

Reader Questions: Code Skin Biopsies Individually

Question: A patient reports to the ED complaining about an itchy red lesion on his left arm and a raised lesion on his left leg. According to the encounter notes, the physician performed a level-two E/M, and then biopsied both areas using a "punch tool." What is the proper code for a punch biopsy? Montana SubscriberAnswer: The punch biopsy code is 11100 (Biopsy of skin, subcutaneous tissue and/or mucous membrane [including simple closure], unless otherwise listed; single lesion). However, you-re selling the claim short if you just report 11100.Why? Coding of biopsies is per lesion, meaning an...

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