Wiki Punch Biopsy vs Excision

[kcaskey03]

I have been reading throught the other posts about punch biopsies and excisions... I need clarification on the punch biopsy, and which CPT codes to use?
Heres an example from i need to code:

1% lidocaine with epinephrine was injectioned subcutaneously around the affected area, total administered 2.5ml The mole on her abdomen measured 7x5x3 mm and was removed with Iris scissors. A 1 mm margin was also made aroudn the lesion area. Suturing was not required. The specimen was placed in formalin and sent to pathology. Antibiotic ointment and sterile dressing applied. The mole on her back measured 4x4 mm and was removed with a 5 mm punch biopsy device with difficulty. No sutures required and antbx ointment followed by sterile dressing were applied. Doctor clarified that the abdomen one was a shave biopsy..

My first hunch is to code the first part (depending on the pathology report) under the shaving of lesions... going off the total size : 11307
and for the punch biopsy of the second part 11100

Im confused if in a different scenario if there was a punch biopsy done AND the specimen was sent off to pathology... do you always use 11100 ; or do you code by excision?

Thanks for any input or advice...

 

[mitchellde]

a biopsy is a removal of only a piece of a lesion, a punch is a tool. If a provider removes the entire lesion with a punch then it is an excision not a biopsy. A biopsy is always sent to path and an excision is always sent to path. The reason to take only a piece of a lesion is to determine the morphology, and the reason for excision is the same thing. A biopsy is more scar sparing.