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preventative codes

Stacy Posted Mon 12th of May, 2014 12:02:20 PM

a patient called to say that her biopsies would have been paid if they had been coded as preventative instead of medical. this confuses me because if would seem that all biopsies of moles taken off and sent to lab would be preventing skin cancer. is there such a thing as a preventative diagnosis code for biopsies of the skin?

SuperCoder Answered Tue 13th of May, 2014 13:48:14 PM

As long as the test is on the preventive care list, the test will be paid at the preventive level as long as your doctor submits the claim with a preventive diagnosis.

This is true even if polyps or other abnormalities are found during a colonoscopy. In this case of an abnormal colonoscopy, the colonoscopy procedure will be paid at the preventive care level, but any pathology charges to evaluate a biopsy would be paid at the medical benefit level.

Stacy Posted Sun 08th of June, 2014 21:32:14 PM

are there preventative diagnosis codes for dermatology visits?

SuperCoder Answered Mon 09th of June, 2014 07:45:27 AM

Good Morning

V82.0 is for Screening for skin conditions, however, if the physician is doing the biopsy to check for skin cancer and other conditions, they typically include those diagnosis as appropriate. Any skin abnormality or suspected abnormality would prompt for a non-preventive diagnosis.
There are other diagnosis for family history and personal history of skin cancer which may also be used if that applies.

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