Wiki Penile Biopsies

[KaylaRieken]

I obtained an elliptical shave biopsy of the distal shaft skin near the coronal margin at the 10 and 2 o'clock position about 5 mm long and 2 mm wide in both lesions. Hemostatis was achieved with bovie cautery. The lesions were closed with running 3-0 monocryl suture and heomostatis was adequate.

My question is do I charge the 54100, 11100, or do I use the skin lesion removal shaving codes? Path report states Keratin granuloma,

 

[ellzeycoding]

If it's just a true biopsy (sampling of portion of the lesion) via shave technique, then use 54100. 11100 would be used for scrotum or pubic area. 54100 is used for the main shaft/head of penis. Site specific biopsy.

 

[KaylaRieken]

When using the 54100 code, can you code this multiple times for multiple lesions. (54100, 54100.59)?

 

[ellzeycoding]

MUEs are 2 on this code. So only billable twice.

Some carriers (like Noridian Medicare) state that modifier 59 is not appropriate as they are not bundled with each other in the NCCI edits listing.

Some carriers will accept modifier 76 as a repeat procedure . Or use 59/XS depending on the carrier's preference.