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Biopsy and Destruction of Lesions

jessica1974

jessica1974

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Louisville, KY
I am new to the dermatology coding world. I am seeing several denials for claims with both the biopsy code 11110 and destruction of lesions 17110. CCI says they can be billed together with a modifier. However according to CPT that's only if they are separate sites. Can someone give me clarification on this? Thanks
 
That's correct, if the provider biopsies a skin lesion and then destroys that same lesion, you cannot bill the biopsy code since it would be bundled. But if the biopsy is done on a different lesion that the one(s) that were destroyed, then a modifier to unbundle the two codes would be appropriate.
 
Yes, Thomas is correct. They are bundled according to the National Correct Coding initiative.

A modifier like XS (or 59) would be appropriate if these procedures were indeed on separate lesions.

However, if the lesion was first biopsied and then immediately destroyed, the carrier won't pay for both on the same DOS.
 
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