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Biopsy code

  1. #1
    Default Biopsy code
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    Is it OK to bill 58100(endo biopsy for irreg mensetruation) and 57500
    (polyp removal together)

    thank U

  2. #2
    Kansas City, MO
    Per NCCI edits Code 57500 is bundled into code 58100 and cannot be unbundled using any modifier. Most insurance carriers today follow NCCI or their edit software is based on NCCI edits.
    Angela Jordan, CPC, COBGC, AAPC Fellow
    Senior Managing Consultant
    Medical Revenue Solutions, LLC
    AAPC National Advisory Board - Southwest
    AAPCCA BOD Chair 2012-2013

  3. #3
    Thank u

  4. Default
    I agree with Angela absolutely.
    but I have a doubt. Leave alone the billing departmental concern. I am not experienced.

    Both of them (58100 and 57500) are 'Separate Procedures'. Which one is bundled into which according to CPT guide/limitations?
    If any one of them is given priority of being the primary, as you pointed 58100 bundles within it 57500, how do we validate ? Is it connected with the more payment value or with CPT guide lines?
    Thank you very much

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