General Surgery Coding Alert

Hint: Wait for the path report to avoid payer scrutiny. If you always use diagnosis code 238.2 (Neoplasm of uncertain behavior of skin) when you're reporting 11100 (Biopsy of skin, subcutaneous tissue and/or mucous membrane [including simple closure], unless otherwise listed; single lesion) for a biopsy procedure your surgeon performs, you're setting your practice up for disaster. The key to knowing when to use the "uncertain behavior" diagnosis code is understanding what that code descriptor really means. Follow these expert tips to ensure you're choosing the correct diagnosis code for all your 11100 claims. Wait For Pathology Before Choosing a Code When your general surgeon performs a biopsy you should always wait until the pathology report comes back to choose the proper diagnosis and procedure codes to report -- even though this will not always affect the CPT code you will wind up choosing. Reason: The biopsy specimen's pathology will affect [...]