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Biopsy one Day, Excision another Day

  1. #1
    Default Biopsy one Day, Excision another Day
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    Our Doc performed a skin biopsy of a site then found out it was malignant from the biopsy path. Then the pt came back in and he excised the lesion. Does the biopsy then fall into the excision code or can it be coded separately? We already billed the bx's. How do we code the excision now? Should we unbill the bx now?

  2. #2
    Albany, New York
    As these two procedures were done at two different sessions, you can most definitely code the biopsy and the subsequent excision of the lesion.
    You may also want to consider modifer 58 on the second procedure.

    No need to retract the submission of the biopsy claim.
    Karen Maloney, CPC
    Data Quality Specialist

  3. #3
    If your doctor did a bx that was billed with CPT 11100 there is no global days attached to that code and therefore no modifier would be necessary to bill for the excision, which will have global days attached.
    Susan Ward, CPC, COC, CPC-I, CEMC, CPCD, CPRC
    AAPC ICD-10 Expert Trainer

    A small act of kindness a day can make someone's day special

  4. Default
    I agree with Susan. If the original procedure was 11100, then you wouldn't need to worry about the excision being denied.


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