Oncology & Hematology Coding Alert

Question: I was working on a pathology report that made reference to a "punch biopsy." What does this mean? Also, the report states that the diagnosis is melanocytic dysplasia, moderate to severe. Should I code this as a melanoma?

Florida Subscriber

Answer: A "punch biopsy" refers to a procedure in which the physician uses a needle with a claw-like tip to take a sample biopsy of the skin lesion. You code this type of biopsy as 11100 (Biopsy of skin, subcutaneous tissue and/or mucous membrane [including simple closure], unless otherwise listed [separate procedure]; single lesion).

For the diagnosis code, your best bet is to select from the 216.x series (Benign neoplasm of skin), the fourth digit required for location.