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Medicare Compliance & Reimbursement

Part B Coding Coach:

Stay Out of These Common Biopsy Coding Pitfalls and Boost Claims Accuracy

Published on Sat Apr 10, 2010

Go beyond 11000 to 'site' specific codes, which can net your practice  upwards of $25. If you automatically assign 11100 when your physician specifies a patient's biopsy site, you could be forfeiting reimbursement that your practice deserves. Using CPT's site-specific codes can dramatically increase your coding accuracy. Plus, they pay more than the most widely used code, 11100 (Biopsy of skin, subcutaneous tissue and/or mucous membrane [includingsimple closure], unless otherwise listed; single lesion). Don't Miss More Pay for More Work Site-specific biopsy codes tell the payer that the physician performed a biopsy at a specific location, rather than a generic integumentary based biopsy (11000). A site-specific biopsy code also represents a more complicated procedure than 11000 does. Result: The doctor deserves more pay for the higher level of complexity of these site-specific procedures. Your practice is losing income if your physicians overlook these site specific codes, which is easy to [...]
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