Wiki 58100 endo bx

[pjn018]

Does anyone know if Medicare cover this biopsy with dx of z71.1? Pt wanted done just because US showed mild thickened endo stripe and fam hx of CA. Any suggestions ?

 

[csperoni]

If the sonogram showed thickened endo stripe, why would you not use R93.8?? Or Z80.# for the family history?
I could not find any Medicare LCD or NCD for CPT 58100.
And my 2 cents personal opinion is that your docs should be making the medical decisions/recommendations, not the patient. If your doc thought it was completely unnecessary and no diagnosis other than patient fear, he/she shouldn't have done the unnecessary procedure. Again, just my 2 cents.