Don't lose money when coding for excision biopsies

Why This Topic Matters

Misclassifying a lesion excision as a biopsy can significantly understate reimbursement and create recurring revenue loss. The article also highlights documentation and reporting issues that affect code selection and payment for dermatology procedures.

Article Sections

1. Coding excision biopsies correctly

   Introduces the documentation and terminology problem that can cause lesion removal services to be coded in the wrong section of CPT. It frames the financial impact on dermatology practices.

2. Excision versus biopsy terminology

   Explains the difference between general lesion excision language and biopsy terminology used in practice notes and billing workflows. It also describes how tissue submission to a lab can add to confusion.

3. CPT coding ranges and related closure considerations

   Reviews the general CPT lesion excision area, mentions related biopsy coding, and notes that separate closure coding and other CPT sections may apply in some situations. It also references payment variation by lesion type and site.

4. Documentation review and pathology report use

   Describes where coders can look in the operative and pathology reports to better understand what was performed. It emphasizes the importance of contemporaneous documentation.

5. Recent and proposed payment updates

   Summarizes mention of a CPT manual update and a CMS proposed payment change affecting lesion excision reimbursement. The section places the article in a broader coding and fee schedule context.

6. Key terms

   Defines the major procedure concepts discussed in the article using broad terminology. It reinforces the article’s central distinction for coding and billing purposes.