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Ear lesion biopsy

  1. Question Ear lesion biopsy
    Medical Coding Books
    Our physician did a biopsy of a lesion in the ear canal and a frozen section that came back as malignant.
    part of the procedure note reads:
    A linear incision was made just in the anterior external auditory canal and the
    deep tissues were dissected free and several specimens were sent for both frozen section and permanent section.The frozen section came back positive for squameous cell carcinoma.

    Would it be appropriate to bill 11640= Excision,malignant lesion including margins,face,ears,eyelids,nose,lips OR 69100= biopsy of external ear. I question this because RVU's are so low on the 69100 and I am not sure if 11640 would be correct as the definition reads "includes margins" ??

    Any suggestions or reference material would be appreciated. Thank you
    Thank you

  2. #2
    Stuart Sailfish Chapter
    Not sure what the total procedure perfomed reads, but have you looked at 69145 (excision soft tissue lesion external auditory canal)
    He/She mentioned that deep tissues were dissected free??
    Just a thought.
    Candice Fenildo, CPC, CPMA, CPC-I, CPB, CENTC, CRHC, AAPC Fellow
    Director of Operations
    Ear, Nose and Throat Associates of South Florida, PA

    "Nothing is stronger than the heart of a volunteer"

  3. Default
    You would use CPT 69105, Biopsy external ear canal; you cannot bill CPT 11640 unless your physician proceeded to remove the entire lesion after the frozen section came back positive for malignancy.

    ENT CT

  4. Smile Thank you Candyr73
    69145 is the most accurate code to bill, many thanks
    Thank you

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