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Podiatry Coding & Billing Alert

Reader Questions:

11100-11101 and 11305-11308: How to Pick Out Biopsy Codes for Skin Lesions

Published on Mon Oct 25, 2010

Question: When does a physician need to obtain a biopsy for skin lesions? What would be the rationale for the decision?Answer: Sometimes, skin lesions are difficult to diagnose as physicians often see an unclear clinical picture. When faced with this dilemma, a physician usually decides to perform a biopsy. If you're billing a biopsy of skin and subcutaneous tissues, you should refer to 11100 (Biopsy of skin, subcutaneous tissue and/or mucous membrane [including simple closure], unless otherwise listed; single lesion) for a single lesion and add CPT 11101 (Biopsy of skin, subcutaneous tissue and/or mucous membrane [including simple closure], unless otherwise listed; each separate/additional lesion [List separately in addition to code for primary procedure]) for each additional (separate) lesion. Closure of the biopsy is included in the procedure fee allowance.Shave biopsy, wherein the physician essentially removes the entire lesion, uses the 11305-11308 (Shaving of epidermal or dermal lesions procedures) code [...]
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