Skin Biopsy Codes

Skin Biopsy Codes

August 8, 2019

Question:
What happened to the skin biopsy codes?  I submitted a claim for 11101 (skin biopsy) and +11101 (additional lesion) and it was denied for “invalid code.”

Answer:
CPT deleted CPT codes 11100 and +11101, effective 1/1/19, and replaced them with the following six new codes:

11102  Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); single
+11103 each separate/additional lesion (List separately in addition to code for primary procedure)
11104 Punch biopsy of skin (including simple closure, when performed); single lesion
+11105 each separate/additional lesion (List separately in addition to code for primary procedure)
11106 Incisional biopsy of skin (eg, wedge) (including simple closure, when performed); single lesion
+11107 each separate/additional lesion (List separately in addition to code for primary procedure)

 

Note that tangential biopsies are partial thickness, punch biopsies require a punch tool and are full-thickness while incisional biopsies are full-thickness.
If multiple lesions are biopsied utilizing different techniques, only one base code (11102 or 11104 or 11106) should be reported (the highest valued code). An add-on code is reported for the additional biopsies.  For example, if one biopsy is performed by punch method and another by incisional method, proper reporting would be 11106 (incisional) and +11105 (punch).

*This response is based on the best information available as of 08/08/19.

 

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