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General Surgery Coding Alert

Biopsies:

Dig Deeper to Get More Pay Than 11100 Delivers

Look beyond integumentary codes for specific tissues.A skin biopsy is a skin biopsy is an 11100 (Biopsy of skin, subcutaneous tissue and/or mucous membrane [including simple closure], unless otherwise listed; single lesion) -- right?Not necessarily. In fact, CPT® provides multiple site-specific biopsy codes for external lesions that you can report instead of 11100, in some circumstances. Let us help you learn how to pick the proper code and save your general surgery practice up to $112 per lesion. Check Out 'Unless Otherwise Listed'You'll notice that the 11100 code definition states "unless otherwise listed." That means you should not use 11100 if your surgeon takes a skin biopsy from a specific site that's listed elsewhere in CPT®.For example: If your surgeon performs a biopsy on a lip lesion, you should report 40490 (Biopsy of lip) instead of 11100. As long as the surgeon notes the site-specific biopsy in the documentation, you should [...]