Units for Biopsies

Units for Biopsies

May 3, 2018

Question:
After practicing for two years, I just learned that the biopsy code 11101 is billed once for each biopsy, not once like 11100.  There was no indication in the computer to bill that way.  How should I have known that?

Answer:
You need to look in the CPT book for the full descriptors.  For 11101, the code descriptor states, Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), unless otherwise listed, each separate additional/lesion.  It is an add-on code, which means that you must bill 11100 for the first lesion biopsy, then use 11101 for each additional lesion biopsy performed.

*This response is based on the best information available as of 05/03/18.

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