I agree with Tessa and this one depends completely on what the documentation is. If the biopsy and destruction were done on the SAME site, then you can't bill for both. You can't unbundle it. You bill the code with the higher RVU in that case. If a biopsy is done on one site and destruction is done on a completely separate site, then you can bill it. ***Anyhow, you can try to use modifier 51 if your insurance carrier allows that along with the 59 modifier. Here's in example:
"Exercise caution when appending the two modifiers for Medicare claims on the same date of service. When a carrier requires the use of the -51 modifier it must be used on the service with lower Relative Value Units (RVUs) while the -59 is attached to the service in the second column of the two lists;
Comprehensive Table and Mutually Exclusive Table. Sometimes, the service in the second column may be the service with the higher RVU.
For example when billing 17000 and 11100, the -51 would be applied to the 17000 since the RVU for 17000 is less than 11100. For Medicare, you would bill 11100 with the -59 modifier and 17000 with the -51 modifier."
Brooke Bierman, CPC, CPB
Coding & Billing Manager
2014 President AAPC Des Moines Chapter