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88304 vs. 88305

  1. #1
    Default 88304 vs. 88305
    Medical Coding Books
    Hello all! I'm brand-spankin' new to derm path coding. I have a good mentor here in the office; but she's not always available. Can anyone recommend a reference to use to help decide where a diagnosis fits ? As an example, what about an Eschar?
    My basic rules thus far; cicatrix/cyst/skin tags/abcess/lipoma/wounds unless from a previous biopsy are 88304s.
    Every day I see more and more skin problems and know I'll need a good resource.
    Thanks in advance!
    Megan, CPCHa

  2. #2
    Default
    This is a terrific resource, but it is a paid subscription. My office subscribes and finds it quite valuable. https://www.apfconnect.org/pathology...g-handbook.php

  3. #3
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    thanks bbooks, our group does have this, it is now on my desktop.

  4. Default
    I have the coding handbook as well, but I have found the scar section to be vague at best. I also have questions.

    Dx: Dermal scar and mixed inflammatory infiltrate.
    Micro: These are nonspecific findings, but they may represent the sequela of a ruptured epidermoid cyst, although no cyst wall or its contents are identified."

    Would this be an 88305 as I do not believe it is a simple scar or 88304 because it "may represent the sequela of a ruptured epidermoid cyst?"
    Last edited by BlakeCarswell82; 12-22-2014 at 09:51 AM. Reason: misspelling

  5. #5
    Default
    Indeed, even the handbook doesn't cover every situation. We continue to struggle with some bone specimens, but that's another topic.

    For this case, I agree. I would code this 88305 and use the diagnosis codes of 709.2 and 686.9, as long as it wasn't a reexcision of a previously diagnosed lesion. The micro confirms non-specific findings and says "MAY represent," which is also non-specific.

  6. #6
    Default
    Quote Originally Posted by bbooks View Post
    This is a terrific resource, but it is a paid subscription. My office subscribes and finds it quite valuable. https://www.apfconnect.org/pathology...g-handbook.php
    I don't have access to this book but I had a question and was hoping you could assist me. Is it true that a provider can bill up to nine units for 88305 then 10 to 20 they use
    G0416? I don't just mean on prostrates but any time when this procedure is used?

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