Dermatology Coding Alert

Question: A patient presents with a suspicious lesion on the lower eyelid. In the chart, the physician writes "basal cell carcinoma" and insists on using 238.2 for every biopsy she thinks is BCC. Is she calling the right shots?

Answer: Yes. Diagnosis code 238.2 is there for you to use so that you don't have to wait for biopsy results to bill your charges. According to the Skin and Aging Web page, there's no reason for you to know the diagnosis to code for a biopsy as reimbursement will remain the same whether the diagnosis turns out to be malignant or benign.

In general, most insurance carriers are oblivious to which of 238.2 and 239.2 you bill because both are routinely covered under their benign lesion policies anyway. Each of them has its own local coverage policies. It is still best to get in touch with your contracted carrier first and find out the exact policies.