Wiki Adding path diagnosis to a skin biopsy

[SUN1633]

We are being posed this question from our ins department. Patient came for a skin biopsy, billed at time of service as unknown skin lesion. (The pathology result came back as skin cancer and patient then had further treatment for it on a different date.) We do not normally hold claims for path when it is only a skin biopsy. This patients particular insurance however will only cover visits related to skin cancer so they are rejecting the biopsy claim. The question is, would it be inappropriate to add to the biopsy claim the pathology proven diagnosis of skin cancer? The provider has signed off on the path report as well. TIA.

 

[thomas7331]

Yes, it is appropriate to bill the biopsy with the final diagnosis per the pathology report - the pathology is part of the record for that encounter. In fact, some organizations will hold the charges and only code the claim after the pathology report has been completed.