Skin Biopsy Codes

Skin Biopsy Codes

February 28, 2019

Question:
What happened to the skin biopsy codes? 

Answer:
CPT deleted CPT codes 11100 and 11101 and replaced them with six new codes:

11102 Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); single lesion (NF Allowable $114.09)
+11103      each separate/additional lesion (List separately in addition to code for primary procedure) (NF Allowable $61.39)
11104 Punch biopsy of skin (including simple closure, when performed); single lesion (NF Allowable $143.48)
+11105    each separate/additional lesion (List separately in addition to code for primary procedure) (NF Allowable $70.21)
11106 Incisional biopsy of skin (eg, wedge) (including simple closure, when performed); single lesion   (NF Allowable $173.50
+11107    each separate/additional lesion (List separately in addition to code for primary procedure) (NF Allowable $82.76)

Tangential biopsies are partial thickness.  Punch biopsies require a punch tool and are full-thickness.  Incisional biopsies are full-thickness.

If multiple lesions are biopsied utilizing different techniques, only one base code should be reported (the highest valued code), with add-on codes 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 and 11105.

*This response is based on the best information available as of 2/28/19.

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