stephanie.henderson
Guest
When billing for a breast bx, is it best to wait for the pathology report to come back to be able to bill with final dx, or can we bill with the reason the bx was done?
Thanks
Thanks
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Wiki Breast Bx- Dx code
nickelclaw
Expert
Must wait on Path to come back. According to coding guidelines must wait on path in order to assign appropriate DX and procedure codes.
mitchellde
True Blue
No it is not required that you wait for the path report for a breast bx. You select the CPT code for the specific procedure perform and they are not specified as to benign or malignant. The dx code selected can match the reason the bx was performed such as N63. You may wait for the path but it is not required. Skin lesion excisions require that you wait for the path before it can be coded.
nickelclaw
Expert
Wouldn't it be better to wait for a specific DX rather than report and unspecified N63?
mitchellde
True Blue
In this case unspecified is acceptable as a code since there is no possible way for the provider to know what the anomaly is. With the exception of skin lesions, the coder may code what is known at the time of coding or may wait for results if a study was performed. As long as you are not assigning a code for a condition the patient does not have and you have a good reason for the use of an unspecified code then you may code without the result. Skin lesion excisions the AMA determined cannot be coded without the path report, which is why those codes only come in benign or malignant flavors.