Wiki Vaginal biopsy coding

[meli990618@gmail.com]

Procedure documentation:
The area(s) was prepped w/ Povidone Iodine. Local anesthesia was achieved w/ Lidocaine 1% w/o Epi.
Lesion 1
Location: LOWER ONE-THIRD 6 O'CLOCK
Size of lesion: 0.5 cm-1.00cm (2 lesions)
excision was performed w/ iris scissors. The lesions were completely removed. Hemostasis was obtained w/ suture.
Lesion 2
Location: upper one-third 7 o'clock
Size: <0.5 cm
The excision was performed w/ iris scissors. The lesions were completely removed. Hemostasis was obtained w/ suture.

The specimen(s) was/were not submitted to pathology-granulation tissue.

My Dr did code 57100 but she says she wasn't sure about this code. I believe the correct code should be 57105 since the tree lesions were sutured. However, I have a few questions in mind, are these codes per lesion or per site, it doesn't specify how many lesions are covered. How would you code this?

Thanks in advance!!!!

 

[nielynco]

Procedure documentation:
The area(s) was prepped w/ Povidone Iodine. Local anesthesia was achieved w/ Lidocaine 1% w/o Epi.
Lesion 1
Location: LOWER ONE-THIRD 6 O'CLOCK
Size of lesion: 0.5 cm-1.00cm (2 lesions)
excision was performed w/ iris scissors. The lesions were completely removed. Hemostasis was obtained w/ suture.
Lesion 2
Location: upper one-third 7 o'clock
Size: <0.5 cm
The excision was performed w/ iris scissors. The lesions were completely removed. Hemostasis was obtained w/ suture.

The specimen(s) was/were not submitted to pathology-granulation tissue.

My Dr did code 57100 but she says she wasn't sure about this code. I believe the correct code should be 57105 since the tree lesions were sutured. However, I have a few questions in mind, are these codes per lesion or per site, it doesn't specify how many lesions are covered. How would you code this?

The AMA clinical vignette used to value code 57100 includes a description of one or more biopsies therefore, since only suturing is the difference between these 2 codes, 57105 would also include one or more biopsies.