2019 Biopsy codes. 69100, 11102 and 11103

Rmn77

Contributor
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11
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Hello,

I am trying to bill a left ear biopsy (69100) along with two shave biopsies (11102+11103). I am getting an edit requesting for a modifier to be put on the add-on code of 11103, because it is butting up against 69100. I was under the impression add-on codes do not require modifiers. Am I wrong or is this a change for the new codes when billed with a specialty site code?

I appreciate any input or advice on this and thank you in advance!
 

TThivierge

Guru
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145
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Lithonia, GA
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Biopsy 3 kinds on one location of ear?

Hello
I believe the CPT 69100 would be best bet. You cannot bill 3 CPT codes all with description of biopsy in same body area.
Try to match your doc's documentation. :)Just saying....

Lady T
 

Rmn77

Contributor
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3 separate biopsies-add on code calling for modifier

It is One left ear biopsy along with two other shave biopsies of different locations. The question was in regards to a modifier being called for on the (add-on) code of 11103. I was under the impression add on codes did not generally require modifiers.
thanks,
 

CatchTheWind

True Blue
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639
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Boca Raton, FL
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The rules for the new biopsy codes are very strange. You pretty much have to check DermCoder or the CCI in each case.

In this case, the add-on code does require a modifier.
 
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