Anesthesia for ear biopsy

Randee

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What code would you give for this scenario?

A healthy 5 year old male is placed under anesthesia to have a biopsy taken from his left ear drum.

a. 00120-P1
b. 00124-P2
c. 00170-P2
d. 00126-P1

I recently had this on a practice exam and thought "a" was the correct answer, but the rationale said that "d" was the correct answer. When I questioned it further the answer was:

"You are correct that otomy = incision. But you need to do an incision to do the biopsy. The difference between 00120 and 00126 is NOS vs. tympanotomy. There are no other specific anesthesia codes for ear procedures. The statement did specify - it said of left eardrum (tympanum). The procedure (biopsy) was done on the eardrum (tympanum) so that is why D is a better choice than A (NOS).

I guess what is confusing to me is that I thought you could actually do a biopsy with a needle and the question didn't state "incisional biopsy".. I am trying not to over think things, but this one keeps staying with me and doesn't seem right.. Should I assume from now on that a tympantomy should be used as a biopsy code? If not, based on the above question, how should I differentiate the two codes in the future?

Thanks so much for any insight you can provide!!
 

chaimz

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I just finished the same practice exam, and I answered the same - A.

I am glad I stumbled upon your thread because I was not satisfied with the rationale that they gave either. However, the further explanation that they gave you answers my question and I will gladly give you my understanding of it.

You must assume that if the type of biopsy isn't specified, it is incisional for the very fact that a biopsy needs to be "cut into" in order to retrieve it. Therefore, being as code 00126 specifies the type of incision (eardrum), and code 00120 includes the biopsy (as the parent code), 00126 would be the correct selection.
 

Shafiq032

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I am not convinced by the answer D because tympanotomy or incisional biopsy is not documented and how can we assume that as default biopsy should be considered as 'incisional' if type of biopsy is not documented. I couldn't find such guidelines anywhere. So I would suggest option 'A' is more appropriate than 'D'.
 
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