tci ED Coding & Reimbursement Alert - 2007 Issue 8

Reader Question ~ Unbundle Biopsy, Destruction With Modifier 59

Question: A patient reports to the ED with three plantar warts on his right foot and a lesion with benign pathology on his left elbow. The physician uses cryosurgery to destroy the warts and takes a biopsy of the elbow lesion. Can I report both services, or is the biopsy bundled into the destruction?Hawaii Subscriber Answer: You can report both services because they occurred at separate sites. Lesion destruction codes typically include biopsy, but only if the physician performs destruction and biopsy on the same site. You can unbundle the services when the physician performs them on separate...

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