If they come in for a biopsy of a mole, then you can't charge an additional office visit. If your physician has never evaluated this mole, then I would bill the office visit with a "neoplasm of uncertain behavior" code (If it needs to be biopsied, then it's uncertain), and then bill the excision with an ICD based on the pathology report.
As far as the acne cyst goes, has this aptient been evaluated for acne cysts in the past? If so, then I would just bill for the injection.
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