I think that we might be incorrectly coding.
Jul 24, 2017 #2 40490 is a biopsy of a lip, not an excision. © 2020 The Dermatologist is a trademark of HMP. Please help. Shave excision: status: active: date introduced: 2002-01-31: fully specified name(s) Shave excision (qualifier value) synonyms: Shave excision: parents: Excision - action 129304002: hierarchies: a selection of possible paths.
Distinguishing exactly how to code each procedure comes down to the details.A biopsy is the most general category of the three. Scar removal is also accomplished with a shave excision, during which an elevated scar is cut with a blade or scalpel.During these operations, the surgeon does not enter the deep layers of skin, and the wound is left to heal on its own. E. ellzeycoding Guest. Or another cpt? By CPT definition, there is no such thing as a shave biopsy. Thanks. Show the two separate sections of CPT for these procedures to him. Mind your coding terms, warns Dr. Kircik, to avoid having RAC auditors down code or issue requests for full refunds. The site is just inside the mouth on the lip. There are codes for shaving of lesions (11300-11313) and there are codes for biopsies of lesions (11100, 11101), but there are no codes for shave biopsies of lesions. If the removal is simply for diagnosis, than it gets coded as a biopsy.
New CPT ® Vignettes. While this may seem like a … When a skin lesion is entirely removed, either by excision or shave removal and sent to pathology for examination, it is not considered a biopsy for coding purposes but an excision and should be reported with the excision codes not biopsy CPT codes. These specialized codes take into account the additional complexity of biopsy at these sites and may better describe the procedure used than the standard codes. Many dermatologists under-code removals of nevi (moles) by charging for a biopsy when, in essence, they are actually performing a shave removal. A recent article published in Cutis notes that for CPT coding purposes, however, they are three separate procedures and therefore should be coded differently. _____ One of the most common questions I encounter during my lectures is when to code a biopsy vs. excision vs. shave removal. Q.
He needs to document clearly whether it is a shave or biopsy that he is performing. These include site-specific skin biopsy codes for the nails, vermilion and mucosal lip, penis, vulva and external ear. Use 40490. Messages 392 Best answers 0. The key distinguishing requirement is that the primary purpose of the procedure is to remove tissue for analysis.This intent differentiates the procedure from shave removal or excision. Would you use 40490 or 11100 for a shave biopsy of the lip? The words biopsy, shave removal or excision may seem like synonyms for the basic procedures; each accomplishes the goal of diagnosing disease, relieving symptoms, and/or treatment. Biopsy is simply described as an “independent procedure to obtain tissue for pathologic examination.” Since the method of biopsy is not defined in the coding it can include: removal by scissors, shaving with a blade or specialized instrument to any level including the subcutaneous fat, extraction using a punch, and excision down to the subcutaneous fat with a scalpel. What is the difference between a shave removal (CPT codes 11300 to 11313) and the biopsy codes (11100/11101)?
This quarterly feature series by expert on dermatology coding, documentation and reimbursement Inga Ellzey will focus on relevant coding issues that most dermatologists frequently encounter.
The words biopsy, shave removal or excision may seem like synonyms for the basic procedures; each accomplishes the goal of diagnosing disease, relieving symptoms, and/or treatment. All Rights Reserved. Shave excision coding is subtly different from biopsy.
If, however, the shave removal is used to completely remove a lesion that already has a presumptive clinical or histologic diagnosis or is being removed for some purpose other than diagnosis (e.g., symptomatic relief), then it gets coded with a different CPT code.Excisions have a more absolute definition: they must proceed through the entire dermis to the subcutis and include margins, as the intent of an excision procedure is to remove the entire lesion along with a margin of normal skin.Adding to the details, there are certain specialized circumstances when more specific codes are best. I am reluctant to use 40490 as it wasn't an excision.
CPT Coding for Biopsies, Shave Removal and Excision: The Differences are in the Details.