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Thread: Biopsy during primary procedure

  1. #1
    Join Date
    Apr 2007

    Question Biopsy during primary procedure

    AAPC: Back to School
    My surgeon does a transection biopsy with his procedures. The procedure is a Whipple procedure and he does a pancreatic biopsy at the transection margins. The biopsy comes back negative but he insists on billing for it.
    I think he shouldn't bill for it unless it changes what the end procedure is going to be be.
    I'm having a hard time fighting with insurance because he's not clearly states that he did the biopsy after he removed the head of the pancreas.
    Am I right on this? CPT 48150 & 48100

  2. #2
    Join Date
    Apr 2007


    Sounds to me like that's included in the primary procedure

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