How To Use CPT Code 56606

CPT 56606 describes the excision of additional lesions in the vulva or perineum, separate from the primary procedure. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 56606?

CPT 56606 can be used to describe the excision of additional lesions in the vulva or perineum, separate from the primary procedure. This code is used when the provider removes suspicious tissue from separate lesions in the external female genital area for further analysis and diagnosis.

2. Official Description

The official description of CPT code 56606 is: ‘Biopsy of vulva or perineum (separate procedure); each separate additional lesion (List separately in addition to code for primary procedure)’. This code should be used in conjunction with CPT code 56605 for the primary procedure. It is important to note that for the excision of a local lesion, different codes should be used (11420-11426, 11620-11626).

3. Procedure

1. The provider prepares the patient and administers anesthesia as necessary.
2. The provider identifies the sites of lesions on the vulva or perineum.
3. Using scissors or a scalpel, the provider excises the lesion from the base of the vulva or perineum along with a surrounding margin of healthy tissue.
4. The excised tissue is sent to a laboratory for analysis and diagnosis.
5. The provider irrigates the area, checks for bleeding, and closes the incision.

4. Qualifying circumstances

CPT 56606 is used when there are additional lesions in the vulva or perineum that need to be excised separately from the primary procedure. The provider must ensure that the patient is appropriately prepped and anesthetized. It is important to note that this code should not be reported when the biopsy is performed as part of a larger, related service.

5. When to use CPT code 56606

CPT code 56606 should be used when there are separate additional lesions in the vulva or perineum that need to be excised. It is important to report this code in conjunction with the primary procedure code, 56605. This code should not be reported if the provider performs a biopsy as part of a larger, related service.

6. Documentation requirements

To support a claim for CPT 56606, the provider must document the following information:

• Identification of the separate additional lesions in the vulva or perineum
• Description of the excision procedure performed
• Documentation of the specimens sent to the laboratory for analysis and diagnosis
• Details of the closure of the incision

7. Billing guidelines

When billing for CPT 56606, it is important to ensure that the code is reported in conjunction with the primary procedure code, 56605. Payers will not reimburse if CPT 56606 is not reported with its primary code. This code should not be reported when the provider performs a biopsy as part of a larger, related service. It is important to follow the specific guidelines provided by the payer regarding the reporting of CPT 56606.

8. Historical information

CPT 56606 was added to the Current Procedural Terminology system on January 1, 1993. There have been no updates to the code since its addition.

9. Examples

1. A provider excising additional lesions in the vulva during a separate procedure from the primary biopsy.
2. A provider removing suspicious tissue from separate lesions in the perineum for further analysis and diagnosis.
3. A patient undergoing the excision of multiple lesions in the vulva, each requiring separate procedures.
4. A provider performing the excision of additional lesions in the perineum, separate from the primary procedure.
5. A patient with multiple lesions in the vulva undergoing separate excisions for each lesion.
6. A provider conducting the excision of additional lesions in the perineum, separate from the primary biopsy.
7. A patient requiring the removal of multiple lesions in the vulva, each necessitating separate procedures.
8. A provider performing the excision of additional lesions in the perineum, separate from the primary procedure.
9. A patient with multiple lesions in the vulva undergoing separate excisions for each lesion.
10. A provider conducting the excision of additional lesions in the perineum, separate from the primary biopsy.