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Wiki 42808 includes 42800?

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wynonna

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Dr. did an excision of right tonsillar lesion and tonsillar fossa area containing lesion was excised in its entirety and sent to pathology.
Do we code 42808 for excision AND 42800 for biopsy? Or does 42808/excision of lesion of pharynx include biopsy? Or do we code 42800 if biopsy includes excision?
Name of procedure is "Excision of right tonsillar lesion" and body of op says specimen sent to pathology.

thank you!
 
42800 is bundled into 42808 but it may billed if a modifier is supported.
I was just teaching this in a class on modifiers
I a biopsy is taken for an unknown outcome (a biopsy has not already been taken and the surgeon does not already know the morphology of the lesion), both the biopsy and ultimate excision can be both coded and billed. But if the morphology was already known and the biopsy was a confirmation biopsy, the biopsy cannot be billed with the excision.

Assuming that the biopsy of the tonsil lesion had not already been taken, then it can be billed, using a 58 modifier on the biopsy, for a staged procedure.
 
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