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Ob-Gyn Coding Alert

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Break Out of Breast Biopsy Denials With This Foolproof Modifier Advice

Published on Tue Aug 21, 2012

If there's more than 1 biopsy, look to 50, 51 and 59.If you're constantly battling payers over the reduction of reimbursements and denials of second procedures along with breast lesion excisions or breast biopsies, this expert coding advice is for you.In most cases, if an ob-gyn performs a breast biopsy, he will only extract a small portion of the lesion. For this reason, you're not likely to report additional codes for wound closure or skin grafts, but you might report more than one biopsy per breast or multiple biopsies in both breasts, says Melanie Witt, RN, COBGC, MA, an independent coding consultant in Guadalupita, N.M.You may also find that you report adjunct procedures such as 1) placement of a clip to identify the site if the biopsy should come back as malignant or 2) radiologic imaging procedures.What to expect: You'll receive full reimbursement for the first biopsy, but payers will [...]
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