tci General Surgery Coding Alert - 2005 Issue 12

READER QUESTIONS: Count Incisions for Biopsy Coding

Question: What are the rules for reporting multiple sentinel node biopsies?California Subscriber Answer: When reporting more than one sentinel node biopsy (38500-38530), you should keep in mind that the number of incisions--not the number of biopsies--determines the number of codes and/or units you should report. Therefore, if the surgeon performs two biopsies through the same incision, you may report only a single code. If the surgeon takes three biopsies from two different incisions, you may report two codes, etc.When reporting more than one biopsy code, append modifier 59 (Distinct procedural service) to the second and subsequent codes...

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