Reader Question:
Report One Biopsy Per Lesion
Published on Sat Apr 03, 2010
Question: Our billing department reported two units of 27613 when our surgeon took two punch biopsy specimens from a single leg site, but the payer denied the second unit. Can we only bill one unit of 27613?Utah SubscriberAnswer: You can bill multiple units of 27613 (Biopsy, soft tissue of leg or ankle area; superficial) -- under certain circumstances. You should limit coding to one unit for a single lesion, but you can report 27613 x 2 if the surgeon documents two separate lesions. Because your example involves one site, you should report only one biopsy code.Problem: Your question is ambiguous because "punch biopsy" usually refers to an integumentary specimen that you should report with 11100 (Biopsy of skin, subcutaneous tissue and/or mucous membrane [including simple closure], unless otherwise listed; single lesion) and +11101 (... each separate/additional lesion [list separately in addition to code for primary procedure]). Note that these codes clearly [...]
