Forum - Questions & Answers

Jun 3rd, 2016 - cmgmr 4 

coding shave biopsy with other procedures

A little help please!

Our Provider performed a shave biopsy 11310 w/dx D48.5 and also treated actinic keratosis 17000-59, 17003, 17003-51 w/Dx L57.0 at the same visit as well. He did not code an office visit just these procedures.

We were paid for the actinic keratosis but not for the shave biopsy. The denial states "Benefit for this service is included in the payment allowance for another service/procedure that has already been adjudicated".

Should there be a modifier on the shave biopsy code? I'm a little confused on this. Any suggestions?


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