Billing for Incisional Biopsies

Billing for Incisional Biopsies

December 5, 2019

Question:
How do we code for 2 separate incisional biopsies – one on the back and another on the patient’s lower lip? Do we use 11106 and 11107 or 11106 and 40490? Do we need any modifiers to make sure the claim is paid?

Answer:
If all are incisional biopsies (not tangential or punch), the you would code 11106 and 40490 – 59, as 40490 is bundled into 11106 but is billable since they are 2 separate lesions on 2 separate anatomic sites.

*This response is based on the best information available as of 12/05/19.

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