Dermatology Coding Alert

Published on Sun Mar 13, 2005 PDF

Question: Our dermatologist recently performed a millimeter punch biopsy that removed the entire lesion from the patient's arm. The dermatologist insists that we report the biopsy code 11100, but I think we should bill a code from the lesion excision series. Could you please explain the difference between punch biopsies and lesion removals?


Massachusetts Subscriber


Answer: In many cases, if your dermatologist performed a punch biopsy, he removed the entire lesion, including the margins. Therefore, you shouldn't report a biopsy code because the dermatologist actually performed a lesion excision.

Therefore, depending on the results of the pathology report, you should report a code from either the benign lesion excision code range (11400-11446) or the malignant lesion code range (11600-11646).

You can also consider reporting one of the shave removal codes (11300-11313), depending on the dermatologist's documentation of the method he used to remove the lesion.