# Punch biopsy or Punch excision



## BlakeCarswell82 (Dec 31, 2014)

I work for a pathology lab. We are being asked to call specimens a punch excision instead of a punch biopsy to correlate with the client's verbiage so they can code for an excision versus a biopsy. To meet the criteria of being a skin excision, the CPT book says, "An excision is defined as full-thickness (through the dermis) removal of a lesion, including margins, and includes simple (non-layered) closure when performed." 

Our pathologists sometimes do not see the subcutaneous fat that proves the excision/biopsy is through the dermis, thus the criteria for "excision" is not objectively met. However, the client's intent is to go through the dermis and, sometimes, the fat does not want to hang on as well with a punch procedure as with a scalpel procedure.

QUESTION:  Does my pathologist need to specify whether or not there is subcutaneous tissue on his microscopic exam to prove that the specimen is an excision?


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