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Muscle biopsy deep vs. superficial

Lisa Posted Mon 26th of April, 2010 18:23:51 PM

How would you define a superficial vs. deep muscle in the codes '20200' and '20205'?

Thanks you,
Lisa May, CPC

SuperCoder Answered Tue 27th of April, 2010 05:43:22 AM

In this case, “superficial” vs. “deep” is a product of distance from the surface (for instance, skin is superficial, bone is deep), rather than a description of the muscle (in other words, just because the quadriceps is a “superficial” muscle doesn’t mean you can’t perform a deep biopsy on it).
The actual muscle the surgeon biopsies (such as biceps, quads, etc.) isn’t the issue -- rather it is how much dissection and how many other structures would have to be dealt with to access the biopsy site.
The surgeon’s clinical judgment may serve as a guide, but as a general rule, you should choose 20205 (Biopsy, muscle; deep) for tissue obtained deep below the fascia, under another layer of muscle or behind bone, while you should choose 20200 (… superficial) for tissue taken just below the surface of the skin or superficially just below the muscle fascia.

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