Incisional Biopsy of Oral Tissue - CDT Code Guide
Overview
CDT code D7286 refers to the incisional biopsy of oral soft tissue. This procedure involves the partial removal of an intact specimen from the oral cavity for diagnostic purposes. Unlike an excisional biopsy, which removes the entire lesion, an incisional biopsy only takes a portion of the tissue, allowing for a histopathological examination to determine the nature of the lesion. This procedure is crucial in diagnosing conditions such as oral cancer, benign tumors, or other pathological changes in the oral tissues. It is typically performed when a lesion is too large to be removed entirely or when the diagnosis is uncertain, necessitating further investigation.
When to Use This Code
- When a suspicious lesion in the oral cavity requires histopathological diagnosis.
- In cases where the lesion is too large for complete removal and a partial sample is necessary.
- When initial non-invasive diagnostic methods are inconclusive.
- To differentiate between benign and malignant lesions in the oral cavity.
- When monitoring changes in a known lesion over time.
Documentation Requirements
- Detailed clinical notes describing the lesion and reason for biopsy.
- Patient consent form for the surgical procedure.
- Pathology report confirming the analysis of the biopsy specimen.
- Pre- and post-operative instructions provided to the patient.
- Photographic documentation of the lesion, if applicable.
Billing Considerations
Ensure that the procedure is not billed in conjunction with apicoectomy or periradicular curettage codes. Verify patient insurance coverage for surgical biopsy procedures, as some plans may require pre-authorization. Use appropriate modifiers if the procedure is performed in conjunction with other oral surgeries. Frequency limitations may apply based on the patient's insurance policy.
Related CDT Codes
Frequently Asked Questions
An incisional biopsy involves removing a portion of the lesion for diagnosis, while an excisional biopsy removes the entire lesion.
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