Wiki bx w/ ed&c

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ashleydbeck1

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La Vista, NE
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I need help settling a dispute in my office. Our providers sometimes do a bx followed by ed&c if they are clinically suspicious of it being malignant. Typically this is only done on older patients, patients who live far from the clinic, or more recently, due to covid and limiting trips/people in the office. I know that you cannot bill for the both the bx AND the ed&c on the same lesion on the same DOS and that these do need to be help for path. If the lesion comes back showing that it was cancerous, then you would bill a malignant destruction (17260-17286). My question is- if the lesion comes back as benign (sk, hyperkeratosis, angioma, etc) or pre-malig (ak), how would you bill that? Would you bill based on intent (destruction)? Or would you bill the bx?
 
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Since both the biopsy and destruction were done (and assuming they're both documented), I would bill whichever one had the higher RVU (17110 or biopsy). The provider did the work on both and so should get paid for the higher value.
 
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