Brush Biopsy: Excision or Extraction?
Published on
Wednesday, August 10, 2022
Did You Know?
The way brush biopsy is coded changed October 1, 2017.
Why It Matters?
Prior to 2017 ICD -10 did not have the option to choose Extraction for the Root Operation. At that time, the only option was to select “Excision”.
Definitions of Excision and Extraction:
- Excision is the cutting out or off, without replacement, a portion of a body part
- Extraction is the pulling or stripping out or off all or a portion of a body part with the use of force.
Physicians like to use the “brush” technique as it is low risk and the least invasive, but still provides enough cells to the Pathologists to make a diagnosis.
In addition, it is important to note the difference between the two approaches because the physician may obtain a specimen using both Excision and Extraction during an operative episode.
For example, during a Bronchoscopy, the physician may perform a brush biopsy of the bronchus and a transbronchial lung biopsy. To obtain a lung biopsy, tiny forceps are used to remove lung tissue, so this would be coded to the approach Excision. The lung biopsy carries a higher risk because there is a chance a pneumothorax will occur. The endoscopic lung biopsy will also group the DRG to a higher weight, which is another reason for being aware of these two approaches.
What Can I Do?
Review Coding Clinic, 4th Quarter 2017, page 41. Closely review the Op Report documentation and note the root operations used during the procedure.
References
- Coding Clinic, 4th Quarter 2017, page 41
- PCS Coding Guidelines
Article Author: Anita Meyers, RHIT, CCS
Anita Meyers, RHIT, CCS, is an Inpatient Coding Professional at Medical Management Plus. Anita has over twenty-six years of experience in inpatient and outpatient coding including 17 years of work at AQAF reviewing inpatient and outpatient records from Alabama hospitals. In addition to reviewing records she was the team leader in Beneficiary Services where she participated in case review activities, received and processed beneficiary complaints and handled fee-for-service denials for home health, hospice and skilled nursing facility services. Prior to joining the MMP team, Anita left AQAF to become an inpatient contract coder and worked at various hospitals in central Alabama. In her current position, Anita is an integral part of the Inpatient Services at Medical Management Plus.
