tci General Surgery Coding Alert - 2010 Issue 5

Reader Question: Report One Biopsy Per Lesion

Question: Our billing department reported two units of 27613 when our surgeon took two punch biopsy specimens from a single leg site, but the payer denied the second unit. Can we only bill one unit of 27613?Utah SubscriberAnswer: You can bill multiple units of 27613 (Biopsy, soft tissue of leg or ankle area; superficial) -- under certain circumstances. You should limit coding to one unit for a single lesion, but you can report 27613 x 2 if the surgeon documents two separate lesions. Because your example involves one site, you should report only one biopsy code.Problem: Your...

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