Biopsy: Increase Accuracy And Success With Site Specific Codes

Posted on 26. Aug, 2012 by dchandhok.

While 11100 (Biopsy of skin, subcutaneous tissue and/or mucous membrane [including simple closure], unless otherwise listed; single lesion)is most commonly reported by dermatology coders, a site-specific biopsy code may help you get your job done better and increase the accuracy of your reporting.

Not only this, a site-specific code will bring in more reimbursement than when you report generic integumentary based biopsy (11100).

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Lesion Method Can Lead You To Integumentary Procedure Coding Success

Posted on 23. Apr, 2012 by dchandhok.

Coding is never easy and even in a case, which appears simple, when a patient comes for treatment of skin lesions, reporting can be complicated. But determining whether your dermatologist performed a biopsy or destruction and these three steps from our experts will make your job easier:

Step 1: Check the Lesion Method

To distinguish between procedure codes 11100-11101, 17000-17004, and 17110-17111, you should first check your dermatologist’s notes for the method he used.

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Make Sure You’re Applying Massive Prostate Biopsy, Urethral Dilation Bundlings

Posted on 20. May, 2010 by Editor.

Modifier 59 sometimes will rescue your reimbursement.

Just when you’re finally getting a handle on all the 2010 coding changes, here comes round two of the Correct Coding Initiative (CCI) edits. Version 16.1, which took effect April 1, will tie your hands when coding many common urology procedures, including prostate biopsies and urethral dilations.

Heads up: CCI 16.1 includes 2,054 new active pairs and 1,947 modifier changes, says Frank D. Cohen, MPA, MBB, senior analyst with MIT Solutions Inc. in Clearwater, Fla.

“For urology, there will be 78 edit pair additions and two edit pair deletions,” says Michael A. Ferragamo, MD, FACS, clinical assistant professor of urology at the State University of New York at Stony Brook.To ensure you get paid appropriately for your urologist’s services this quarter, here’s the rundown of the most important changes.

Say Goodbye to Biopsy with Several Prostate Procedures

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OIG Hit List: Perfect Your 38220, 38221, and G0364 Usage

Posted on 22. Feb, 2010 by Editor.

Don’t sweat reporting 38220-59 if you meet these Medicare-approved conditions.

If your oncologist takes both a bone marrow biopsy and a bone marrow aspiration, whether you’ll see Medicare reimbursement depends on the two guidelines below. But watch out: With OIG scrutiny and a HCPCS twist, these guidelines will put your coding savvy to the test.

Append 59 for Different Sites and Encounters

Because a bone marrow biopsy and a bone marrow aspiration can provide different diagnostic information for certain leukemia evaluations, taking both specimens from the same patient on the same day isn’t unusual, according to R.M. Stainton Jr., MD, president of Doctor’s Anatomic Pathology in Jonesboro, Ark.

Snag: Medicare and some other payers use the Correct Coding Initiative (CCI) edits to restrict how you bill for “sequenced” surgical procedures through the same incision. For biopsy and aspiration, CCI bundles the following codes:

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How Do You Code Sigmoidoscopy with Anoscopy, Biopsy?

Posted on 13. Oct, 2009 by .

Question: Notes indicate that the gastroenterologist performs a rigid sigmoidoscopy; during the encounter, he also performs an anoscopy without anesthesia and three biopsies of the mucous membrane. How should I report this episode? Can I report the exam separately with 46600?

Answer: You can report a single code for these three services. On the claim, report 45305 (Proctosigmodoscopy, rigid; with biopsy, single or multiple) for the sigmoidoscopy, the anorectal exam, and the three biopsies.

Why: When the gastroenterologist performs an anoscopy (46600 [Anoscopy; diagnostic, with or without collection of specimen[s] by brushing or washing [separate procedure]) or mucous membrane biopsy during a sigmoidoscopy, the services are bundled into 45305.

AUDIO TRAINING EVENT: Colonscopy Coding Clinic with Jill Young. How to code screening-turned-diagnostic colonscopies, documentation musts, modifier musts, compliance heads up & more.

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