Ob-Gyn Coding Alert

Learn how CPT 2006 changes the way you report endometrial biopsies

Are you sure you-re getting the reimbursement your ob-gyn deserves for biopsy procedures? Take this quiz and avoid the many pitfalls of biopsy coding and billing.

First, Heed This Advice for Biopsies

A biopsy is a tissue sample that the ob-gyn excises from the patient to ascertain the presence of cancer. Ob-gyns will most likely perform biopsies of the vulva, cervix, vagina, endometrium and ovary(s). Ob-gyns usually order a biopsy as a result of abnormal vaginal bleeding or after the detection of a mass, cyst, lump, tumor or cells of abnormal appearance.

Best bet: You should code all of your biopsies with the copy of the pathology report to back up your diagnoses. -We have the lab drop off the results to our billing office prior to the nurses- getting them. We make the copy and then disburse them to the nurses all in the same day,- says Denell Engstrom, CPC, a coding specialist at the Woman's Clinic in Boise, Idaho. -This doesn't delay results getting to the physician, and this way we submit the charge correctly the first time.-

Make this a rule when you-re coding biopsies, and your claim is sure to sail.

Next, Consider These 3 Questions

Try your hand at coding these biopsy scenarios:

Question 1: The ob-gyn performs an ovarian biopsy laparoscopically. The biopsy reveals malignancy, so the ob-gyn converts to an open procedure to remove the ovary(s). What should you report?

Question 2: A patient with irregular intermenstrual bleeding (626.6) undergoes an office procedure in which  the ob-gyn extracts samples from the tissue lining the inside of the uterus (endometrium). He inserts a plastic catheter into the uterus and suctions out a small amount of the endometrial lining. What should you report?

Question 3: A patient presents with an abnormal mole, lesion or other dermatosa on the vulva that hasn't responded to topical or other conventional treatments. With topical anesthesia, the ob-gyn takes three samples. What should you report?

Compare your answers to the experts- in the next article.