tci General Surgery Coding Alert - 2004 Issue 8

Biopsy and Excision at the Same Time? Think Again

Reserve 11100/11101 for pathology specimens only If you're reporting biopsy codes 11100 and 11101 separately from excisions or other biopsies, you're setting yourself up for denials and a possible audit. To avoid these problems, you should use 11100/11101 when the surgeon obtains a portion of a lesion for pathology only. New Instructions Clarify Bundles Instructional notes added to CPT 2004 clarify that you shouldn't report 11100 (Biopsy of skin, subcutaneous tissue and/or mucous membrane [including simple closure], unless otherwise listed; single lesion) and +11101 (... each separate/additional lesion [list separately in addition to code for primary procedure]) in addition...

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