Multiple Biopsies

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November 25, 2014

Question:

We did multiple biopsies on the same lesion. So we know we can code 11100 for a single lesion and 11101 if we have multiple lesions. But what do we code if we have one lesion where we did multiple biopsies? Are we still OK to use 11101?

Answer:

CPT 11100 says “Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), unless otherwise listed; single LESION” (I added the emphasis on lesion). The code is reported per lesion, not per number of biopsies of the lesion. Therefore, you would report only one code for a lesion in which multiple pieces of tissue (biopsy) are taken. So 11100 is for a single lesion with one or more/multiple biopsies.