jenmendoza

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Sacramento, CA
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Hello!

I would like to kindly inquire regarding the proper coding for biopsy, especially if there is more than one type of biopsy done during a patient's single visit. The scenario will be as follows:

Scenario One:
Patient came in for a visit, and ended up having one punch biopsy and two shave biopsies.
Question:
Considering the above, do we code it as the following below?

E/M Code; mod 25
11104; qty. 1
11103 qty. 2

Scenario Two:
Patient came in for a visit, and somehow ended up having 2 incisional biopsies, one punch biopsy, and one shave biopsy.
Question:
Considering the above, do we code it as the following below?

E/M Code; mod 25
11106; qty. 1
11107; qty. 1
11105; qty. 1
11103; qty. 1

I am under the impression that when coding biopsies, the priority of order would be incisional > punch > shave in terms of reimbursement when pushing the claim through charge review. Is this correct by any chance?
TYIA for the responses! 😸
 
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