- CPT updated certain skin biopsy codes in 2019
- The codes for excision of benign and malignant lesions did not change, and codes for shave biopsies didn’t change
- There are still specific biopsy codes in other chapters, for biopsy of ears, lips, genital areas, and others
- Now, there are codes for incisional biopsy, punch biopsy and tangential biopsy
Is that all clear? Read on!
In 2019, CPT® deleted codes punch biopsy code 11100 and add-on code +11101 and replaced these codes with six new biopsy codes.
Using these codes indicates that the procedure was:
“to obtain tissue solely for diagnostic histopathologic examination when performed independently, or was unrelated or distinct from other procedures/services provided at the that time.” [1]
Biopsy code 11100 and 11101 deleted in 2019
These codes are not defined by location or size, but are defined by the method of obtaining the biopsy. There is no need to wait for pathology when reporting these new codes.
Our billing guide for Minor Surgical Procedures provides an in-depth look at coding guidelines for procedures with 0 to 10 global days, including biopsies.
| Code | Description | 2020 Work RVUs | National non-facility payment | National facility payment | Global Days |
| 11102 |
Tangential biopsy of skin (e.g., shave, scoop, saucerize, curette) single lesion |
0.66 | $102.49 | $40.42 | 0 |
| +11103 |
each separate/additional lesion (List separately in addition to code for primary procedure) |
0.38 | $54.50 | $23.46 | ZZZ |
| 11104 |
Punch biopsy of skin (including simple closure, when performed) single lesion |
0.83 | $128.84 | $50.53 | 0 |
| +11105 |
each separate/additional lesion (List separately in addition to code for primary procedure |
0.45 | $62.07 | $27.43 | ZZZ |
| 11106 |
Incisional biopsy of skin (e.g., wedge) (including simple closure, when performed) single lesion |
1.01 | $155.91 | $60.99 | 0 |
| +11107 |
each separate/additional lesion (List separately in addition to code for primary procedure) |
0.54 | $73.62 | $32.84 | ZZZ |
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