CODING & DOCUMENTATION

Yes, to a point. Current CPT guidance is to delay coding and billing until the pathology has been confirmed, unless the excised lesion is clearly benign or clearly malignant. This is true regardless of the method of excision. If you are confident the lesion is clearly benign or clearly malignant, you may code it as such up front and then file a revised claim if the pathology report says otherwise.

For ICD-10 coding, when you're unsure whether the lesion is benign or malignant, either hold the claim until the pathology report is available or submit an unspecified diagnosis code. Do not report codes for neoplasms of uncertain behavior unless the pathologist's report reflects that (e.g., a lesion that may be transitioning to malignancy).

Medicare Part B covers routine immunizations against COVID-19, pneumococcal illness, hepatitis B, and influenza. (Other routine recommended immunizations, such as RSV and zoster, are covered under Part D.) When reporting routine immunization, use the appropriate CPT code for the vaccine product and an appropriate immunization administration code:

• 90480 for administration of COVID-19 vaccine,
• G0008 for administration of influenza virus vaccine,
• G0009 for administration of pneumococcal vaccine,
• G0010 for administration of hepatitis B vaccine.

Link diagnosis code Z23 (encounter for immunization) to the vaccine product and administration codes. You may report other ICD-10 codes secondary to Z23 to indicate immunization in patients who have an underlying condition or other risk factor such as diabetes mellitus or end-stage renal failure.

Medicare Part B also covers non-routine vaccines, antitoxins, antivenin sera, and immune globulins administered to treat injury or direct exposure to a disease or condition (e.g., tetanus antitoxin or vaccine booster). Link a diagnosis code for the injury or other condition (e.g., S91.331A for puncture wound without foreign body, right foot, initial encounter) to the product and administration codes (e.g., 90471, immunization administration by injection).