Wiki Biopsies SCC nose lesion

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seslinger

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Can I charge 11100 plus 11101 x5 for the following:

... six biopsies were done, consisted of the medial deep margin biopsy involved tissue about the distal portion of the nasal bones inclusive of nasal mucosa. The lateral deep margin involved the tissue about the piriform aperture on the right. The inferior deep margin involved the tissue from the nasal floor region of the nose. The right lateral skin of the ala was biopsied. The deep superior margin involved tissue overlying the lateral nasal bone maxilla area near the nasal ala, and the anterior septum soft tissue and cartilage was also biopsied.

No closure was done. Also, I wanted to make sure I should not be billing the 11640.

thanks for any imput.
Sheila
 
You would need the pathology report (malignant or benign) and the size of the excision's to code the 11640. I would wait for the pathology report before coding. I hope this helps.
 
ok per the path, there were 6 pieces that states "excision" 2 of the 6 came back SCC the other 4 state no malignancy. Thats what confused me as to code the biopsy coded or excision code.
 
seslinger said:
ok per the path, there were 6 pieces that states "excision" 2 of the 6 came back SCC the other 4 state no malignancy. Thats what confused me as to code the biopsy coded or excision code.
Click to expand...

code malignancy first and any additional dx per path report. code procedure to the highest severity.
 
In my experience, you physician would need to dictate the "excision" and the size of each. While closure is not required for an excision code, there is usually some kind of closure... Maybe that is why it was dictated as biopsies. I have also been told, and agree, that it is necessary to record the size of a lession's margins at the time of excision as shrinking and expanding can occur prior to pathology measuring. For these reasons I would use the 111-- codes in this case. It may be constructive to inform you physician that when he records excision and the size he will possible be reimbursed more.
 
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