Medical Coding

Category - 40,000 Series

Mr. Johnson, a 46-year-old male, has smoked cigars for the last 20 years of his life. He has a suspicious lesion on his lower lip and is being seen for treatment. The physician suspects that it may be malignant. The physician performed a shave biopsy of the patient’s lower lip. What is the correct code for this procedure?
  1. 40490
  2. 40500
  3. 11100
  4. 11600
Explanation
Answer: A - Code 40490 (Biopsy of Lip) is the correct code for this procedure. Code 40500 (Vermilionectomy (Lip Shave), with Mucosal Advancement) is not correct because it is a more extensive procedure than what was performed at the visit, which was just a biopsy. Code 11100 (Biopsy of Skin) is also not correct because the code 40490 is used for the lip, which is more specific.
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