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.