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2025 CPT code 56606

Biopsy of vulva or perineum (separate procedure); each separate additional lesion.

This is an add-on code and should only be reported with 56605, which is the primary procedure for biopsy of vulva or perineum.Each additional lesion requires a separate report of 56606.

Modifiers may apply based on the circumstances of the procedure and other services provided.Consult the AMA CPT manual for specific modifier guidelines.

Medical necessity is established based on the clinical indication of suspicious lesions.This includes documented findings (physical exam, imaging) supporting the need for excision and subsequent histopathological evaluation to diagnose or rule out malignancy or other conditions.

The physician identifies, excises, and sends tissue samples for analysis.Post-procedure care includes irrigation, hemostasis, and wound closure.

IMPORTANT:Use 56606 only with 56605. For excision of a single local lesion, consider codes 11420-11426 or 11620-11626.

In simple words: This code is for removing extra suspicious tissue from additional sores or growths on the vulva (outer female genitals) or perineum (area between the vagina and anus). The removed tissue is sent to a lab for testing.

This CPT code, 56606, reports the excision of each additional lesion in the vulva or perineum, beyond the initial lesion addressed by 56605.It's an add-on code requiring the primary code 56605 for proper billing. The procedure involves excising suspicious tissue from the lesion, including a margin of healthy tissue, and submitting the specimen for pathological analysis.The area is then irrigated, hemostasis is achieved, and the incision is closed.

Example 1: A patient presents with a primary vulvar lesion (coded with 56605) and two additional smaller suspicious lesions.Code 56606 is used twice to bill for the excision of each additional lesion., A patient undergoes a vulvectomy (56620-56640) during which additional suspicious tissue is found and excised. Code 56606 is used to separately bill for these additional excisions., A patient presents with multiple vulvar lesions which are biopsied in one session. Code 56605 is used for the primary lesion and 56606 for each subsequent lesion.

Complete documentation should include pre-operative diagnosis, operative report detailing the number and location of lesions excised, description of the tissue removed (including margins), pathology report confirming the nature of the lesions, and post-operative course.

** Always confirm the number of lesions excised and appropriately report 56606 for each additional lesion beyond the first (coded with 56605).Incorrect use of this add-on code may lead to claim denials.

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