wilccm
Contributor
Can someone tell me the different methods to do a biopsy of skin. I have a doctor that wants to bill 11300 x 3 for 3 different lesions on back. The dx code that the provider is using is 702.19
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Wiki 11100
- Thread starter wilccm
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mitchellde
True Blue
a biopsy is coded when the documentation states only a piece of a lesion is removed and sent to path, a shave is when the entire lesion is removed at a depth of partial thickness (not thru the dermis), and an excision is removal of the lesion at a depth of full thickness. So it depends on how the note describes the procedure performed. Also you cannot bill multiples with units each removal must be listed separately.
m.edwards
Networker
A biopsy can be performed using a razor blade, scalpel, or a punch biopsy tool. As stated above, in a biopsy, only a portion of the lesion is removed. For 11300, a shave removal, the entire lesion must be removed using a shave technique and coded based on lesion size (not based on margin size like excisions).
The definition of the procedure 11300 is as follows:
"The physician removes a single, elevated epidermal or dermal lesion from the trunk, arm, or legs by shave excision. Local anesthesia is injected beneath the lesion. A scalpel blade is placed against the skin adjacent to the lesion and the physician uses a horizontal slicing motion to excise the lesion from its base. The wound does not require suturing and bleeding is controlled by chemical or electrical cauterization."
https://www.encoderpro.com
Some comercial payers will accept this code billed as units, other will want separate line items on the claim. It is payer specific. According to Medicare's Illinois Quantity Bill List, you are allowed to bill 11300 as units (no quantity limit set) and do not have to list them as single line items.
(For other state quantity bill lists, you should be able to locate them on Medicare's website.)
The definition of the procedure 11300 is as follows:
"The physician removes a single, elevated epidermal or dermal lesion from the trunk, arm, or legs by shave excision. Local anesthesia is injected beneath the lesion. A scalpel blade is placed against the skin adjacent to the lesion and the physician uses a horizontal slicing motion to excise the lesion from its base. The wound does not require suturing and bleeding is controlled by chemical or electrical cauterization."
https://www.encoderpro.com
Some comercial payers will accept this code billed as units, other will want separate line items on the claim. It is payer specific. According to Medicare's Illinois Quantity Bill List, you are allowed to bill 11300 as units (no quantity limit set) and do not have to list them as single line items.
(For other state quantity bill lists, you should be able to locate them on Medicare's website.)