# punch biopsy



## Asmith2284 (Dec 12, 2014)

I need some help coding the following:

Patient was placed in prone position.  Skin area of 4 lesions was cleaned/ prepped in sterile fashion with betadine solution.  0.5mL of lidocaine with Epinepherine was injected subcutaneously under each lesion for anesthesia.  Lesion on L shoulder, and R lower back were removed using 5mm punch biopsy tool.  Lesion over T7 was removed using 6mm punch biopsy tool.  Lesion over C7 was removed using 15 blade scalpel.  Bleeding of all lesions was stopped with pressure.  Tripple antibiotic ointment and sterile bandages were applied to all lesions.  Patient was instructed to call for any signs of infection or bleeding that was not controlled with bandages

TIA!

we billed it as followed:

11421
11100-59
11101-51-59
11101-51-59

i'm thinking we should removed the mod 59 from the 11101's??


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## mitchellde (Dec 12, 2014)

If the entire lesion is removed using a punch tool then it is an excision as a punch tool goes to a full thickness depth. You cannot code an excision until you have the path report.  The lesion removed with the scalpel must be documented as either par thickness or full thickness before it can be coded as eith an excision or a shave removal.


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