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Thread: Biopsy of the ear

  1. #1

    Default Biopsy of the ear

    AAPC: Back to School
    When a doctor takes a biopsy of the ear how do you determine if you code it a 11100 or 69100?
    Thanks for any help!!

  2. #2
    Join Date
    Apr 2007
    Albany, New York


    Please refer to the CPT Assistant below.

    Since there is a "site specific" code for biopsy of the ear, I would go
    with 69100.

    Biopsy of Skin, Subcutaneous Tissue and/or Mucous Membrane

    CPT code 11100 describes the biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), unless otherwise listed. Since there are specific breast biopsy codes, this more generic biopsy code would not be reported for breast biopsies. The "unless otherwise listed" phrase indicates that you should look for a more specific code under the anatomic location of the site from which the physician is taking the biopsy. If there is not a more specific code in that section, then you can "default" to this code. However, in the case of breast biopsies, there are specific codes and this generic code (11100) would not be reported for a breast biopsy.

    11100 Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), unless otherwise listed (separate procedure); single lesion

    11101 each separate/additional lesion

    Note from 3M:
    As of January 1, 2004, code 11100 has been revised. It is no longer designated as a separate procedure.

    CPT Assistant © Copyright 1990–2008 American Medical Association. All Rights Reserved
    Karen Maloney, CPC
    Data Quality Specialist

  3. #3
    Join Date
    Apr 2007
    North Carolina


    I agree with Karen; use 69100.

    Coders Desk Reference:

    69100-The physician uses a scalpel or punch forceps to excise a portion of a lesion on the external ear for diagnostic purposes. Unless the incision is large, a sutured closure is usually unnecessary.

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