Excisional Biopsy

Question:

My physician is insisting that I bill an excision biopsy using a punch as a punch biopsy (11104). The documentation says the lesion was removed in its entirety. Is this a biopsy of lesion excision. She does not document the cm size of the removal.

Answer:

Skin biopsy procedures can be grouped by how much of the lesion is removed. If you have an excisional biopsy, the entire lesion is removed. Examples of excisional biopsy procedures include elliptical excision, deep scoop shave, and punch biopsy for small lesions. Codes should be reported with the excision codes 11400-11471 (benign lesions) or 11600-11646 (malignant lesions). The practice should wait for the pathology report for correct coding. The physician should document the anatomic location, method of removal and cm size at a minimum.