Ob-Gyn Coding Alert

Question: What procedure should I bill when the ob-gyn did a vulvar biopsy? The pathology says skin tags? Do I change and use the skin tag code 11200 with 701.9, or do I still bill the vulvar biopsy code 56605 with 701.9?

Tennessee Subscriber

Answer: The ob-gyn did a biopsy, not removal of a skin tag lesion. Therefore, you should go with 56605 (Biopsy of vulva or perineum [separate procedure]; 1 lesion). You actually have two different diagnostic code options: 701.9 (Unspecified hypertrophic and atrophic conditions of skin) or 624.8 (Other specified noninflammatory disorders of vulva and perineum), which is the code that the index refers you to for tags of the vulva.

ICD-10: When your diagnosis coding system changes, 701.9 expends into multiple options:

·         L85.9 — Epidermal thickening, unspecified

·         L87.9 — Transepidermal elimination disorder, unspecified

·         L90.9 — Atrophic disorder of skin, unspecified

·         L91.9 — Hypertrophic disorder of the skin, unspecified

·         L94.9 — Localized connective tissue disorder, unspecified

Careful:  If you look in the ICD-10 alphabetic index under the term “tag” you will see a reference to “skin” that leads you to code L91.8 (Other hypertrophic disorders of the skin) instead of the codes listed above so be sure to always check the index instead of relying on translation tables. 

The code 624.8 expands to three options:

·         N90.3 — Dysplasia of vulva, unspecified

·         N90.7 — Vulvar cyst

·         N90.89 — Other specified noninflammatory disorders of vulva and perineum.