tci Part B Insider - 2013 Issue 30

Reader Question: Use Caution When Separating CCI Edits

Question: During a breast biopsy, the surgeon also performed a scar revision involving multi-layered closure relating to the patient’s prior breast reduction surgery. Can we separately code the scar revision in addition to the biopsy code? Should we list V50.1 for the history of breast reduction surgery to show medical necessity for the scar revision? Michigan Subscriber Answer: Yes, you can separately report the scar revision in addition to the biopsy (such as 19101, Biopsy of breast; open, incisional) if they occur at different locations. You cannot bill both if the biopsy is in the scar-revision area...

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