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11100 vs 19101 help please

beausolb

Contributor
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14
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Hi,
I can't agree with 19101 for this, please help.

Here's the procedure note:
74 yo woman with 2x2 cm rash of rt nipple for 1 month.
Inc. bx under 2% lido
rep with 6-0 vicryl and steristrips

Path note:
Speciman labeled rt nipple bs, tissue measuring 0.8 x 0.5 cm
dx: subacute spongiotic dermatitis; no evidence of malignancy

Something so simple is giving me a headache!

Thanks
 

Hopp

Guru
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11100 vs 19101

I'm at home and do not have my CPT book with me; however I do believe that
code 11100 is for Punch Biopsies and not for an incisional bx. Hope this helps as
I don't have my CPT book with me.
Debbie Hopp - CPC-A
 

heathermc

Guest
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109
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I say 19101 after reading the description in the coders desk reference. It states that the physician removes tissue for biopsy. He makes an incision in the skin of the breast near the site of the suspected mass. The mass is identified and a sample of the lesion is removed. Hope this helps.
 

beausolb

Contributor
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14
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Hi,
Thaks for the responses, I know the rule for this coding, but for some reason my MIND(or lack of it) wouldn't let it go!! Of course the 19101 stands!
 

myadav

Contributor
Messages
10
Location
amarillo texas
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Hi
It should be 19101, It is more specific to description.

The physician removes tissue for biopsy. The physician makes an incision in the skin of the breast near the site of the suspect mass. The mass is identified and a sample of the lesion is removed. This specimen is often examined immediately. If the lesion is benign, the incision is repaired with layered closure. If malignant, the incision may be closed pending a separate, more extensive surgical session, or a more extensive surgery may occur immediately

Myadav, cpc
 
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