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Oncology & Hematology Coding Alert

Reader Question:

Punch In a Simple Code for Biopsy

Published on Thu Jan 01, 2004

Question: I was working on a pathology report that referenced a "punch biopsy." What does this mean? Also, the report states that the diagnosis is melanocytic dysplasia, moderate to severe. Should I code this as a melanoma?

Florida Subscriber Answer: During a "punch biopsy" the physician uses a needle with a claw-like tip to take a sample biopsy of the skin lesion. Report this procedure as 11100 (Biopsy of skin, subcutaneous tissue and/or mucous membrane [including simple closure], unless otherwise listed; single lesion).
 
For the diagnosis code, you should select from the 216.x series (Benign neoplasm of skin), the fourth digit required for location.
 
- Answers to Reader Questions and You Be the Coder were provided by Linda L. Lively, MHA, CCS-P, RCC, CHBME, founder and CEO of American Medical Accounting and Consulting in Marietta, Ga.; and Margaret M. Hickey, MS, MSN, RN, OCN, CORLN, an independent oncology coding consultant based in New Orleans.
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