Wiki Vulvar biopsy

[mvaldivia@ivfcmg.com]

Provider did excision biopsy of left labia, posterior vaginal fourchette, right perineum
He coded as 56605 primary lesion, 56606 second and 56606 for the third one.
Medicare paid for 56605 and only one 56606.
56606 should of have had been billed as 56606x2 instead of individual excisions.
Help.

Thank you

 

[csperoni]

I'm sorry, but I don't understand what you are asking. You state you billed:
56605
56606
56606
but should have billed
56605
56606 x2
You would need to correct the claim with Medicare.

 

[mvaldivia@ivfcmg.com]

I am sorry for not being clear with my question.
Provider charged for 3 cryo
main one 56605 and 56606 for the second and 56606 third lesions.
my question is . Were we suppose to have billed services as 56605 for the primary cryo and 56606 for 2 units (for the 3rd and 4th lesion)

Thank you

 

[csperoni]

I do not believe there is a "rule" about this. However, if you list the same code twice, many carriers may simply think this is a duplicate and deny the second - which may be the case in your situation.
If the carrier has a specific policy, I would bill per that policy. Otherwise, I would suggest to bill as
56605
56606 x2
to avoid any confusion.

 

[mvaldivia@ivfcmg.com]

thank you