If you suspect that a lesion might be malignant, it is recommended to hold off on billing for the excision until you are able to view the pathology results from the lab. At that time, you would bill the appropriate excision code – 13620 if not malignant, 13622 if positive for malignancy.
If you have already billed 13620 and subsequently the pathology comes back as malignant, a debit bill can be submitted to Teleplan for 13620. After waiting a few days to allow the MSP computer to process the debit, submit a new bill for 13622 for that same date of service (13622 has a higher fee value).
Tips:
- 13620 and 13622 are billable with a visit when the visit is for an unrelated reason. Bill the highest value fee at 100% plus the lower value fee at 50%.
- A major tray fee is billable with 13620 and 13622.
Please see this FAQ in the Billing Question Library for a how to bill for a biopsy that requires no sutures.