AAPC - Back to school
Results 1 to 4 of 4

Thread: Biopsy one Day, Excision another Day

  1. #1
    Join Date
    Apr 2007
    Indianapolis, IN

    Default Biopsy one Day, Excision another Day

    AAPC: Back to School
    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
    Join Date
    Apr 2007
    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
    Join Date
    Apr 2007


    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. #4


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


Similar Threads

  1. Excision of Benign lesion and Skin tag same day
    By CMW in forum Billing/Reimbursement
    Replies: 1
    Last Post: 03-19-2014, 04:54 PM
  2. Replies: 0
    Last Post: 11-22-2011, 11:23 AM
  3. Bone Marrow Biopsy Day
    By tandb01 in forum Hematology/Oncology
    Replies: 0
    Last Post: 09-27-2011, 01:55 PM
  4. Replies: 0
    Last Post: 02-03-2010, 02:58 PM
  5. modifier for skin excision/flu shot same day??
    By misstigris in forum Modifiers
    Replies: 1
    Last Post: 11-04-2009, 03:46 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.