More than 300 new CPT codes were released for 2019, and the 2019 Current Procedural Terminology code set included some significant changes to both codes and descriptors. One of the most significant changes for the coming year – skin biopsy deletions, updates, and revisions – will have a bit effect on dermatology practices. Skin biopsies are one of the most commonly performed procedures by dermatologists, so essential to stay current on skin biopsy codes. Before the calendar turns to the new year, here’s a closer look at what your practice needs to know about coding skin biopsies.
Previously Used Skin Biopsy CPT Codes
The two previously primary CPT codes for skin biopsies include:
- 11100 – Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), unless otherwise noted
- 11101 – Biopsy of skin for every additional lesion that’s biopsied after the first lesion on the same day.
With these codes, you were able to report various methods of removal, whether it was by blade, shaving, specialized instrument, or scissors. It was discovered that dermatologists were using the two codes inconsistently, so these two codes will no longer be used in 2019.
Six New CPT Codes for Skin Biopsy
The new CPT codes for 2019 now included six different codes that can be used for skin biopsies. These new codes provide great specificity surrounding the depth and technique of a biopsy. The new CPT codes for skin biopsies include:
- 11102 – Tangential biopsy of the skin (i.e., scoop, curette, shave, saucerize) a single lesion
- 11103 – Used for each additional/separate lesion (list separately along with the code for the primary biopsy)
- 11104 – Punch biopsy of the skin (including simple closure if performed) for a single lesion
- 11105 – Every additional/separate lesion (should be listed separately along with the code for primary biopsy)
- 11106 – Incisional biopsy of the skin (i.e., wedge) (along with simple closure if performed) single lesion
- 11107 – Every additional/separate lesion (list separately along with the code for the primary biopsy
With these new codes, dermatology practices will need to code biopsies based on the method of removal. Tangential biopsies describe biopsies performed with a sharp blade to take a small portion of epidermal tissue. Punch biopsies require using a punch tool to remove a cylindrical, full-thickness skin sample. Simple closure is included. Incisional biopsies are done with a sharp blade and involved removing full-thickness samples with a wedge or vertical incisions. These biopsies penetrate into the dermis.
Using codes for tangential, punch, and incisional biopsies indicate that you’re obtaining a tissue sample for a diagnostic histopathologic exam and that the biopsy was performed independently or was distinct from any other services that were provided at the same encounter.
Tips for Coding Skin Biopsies
A few tips to keep in mind as you begin using the new 2019 codes for skin biopsies include:
- Only one primary biopsy code should be reported if more than one biopsy is performed at the same visit.
- If multiple biopsies are performed with the same technique, report the corresponding biopsy code and then use the add-on code for every additional lesion that’s biopsied.
- If you are excising the entire lesion, you’ll need to use excision codes 11400-11646 depending on whether the lesion is malignant or benign.
- Don’t forget to document the anatomic site and the method of removal when coding biopsies.
- You don’t always have to wait for a pathology report before you submit the codes for a biopsy. The only time you need to wait is if it was an excisional biopsy, which will be coded based upon the pathology report. You may submit a claim for other types of biopsies (i.e., breast biopsies, punch biopsies, tangential biopsies, incisional biopsies, and fine needle aspirations) on the same day that the service was performed.
Keeping up with dermatology coding updates is essential for keeping practice revenue flowing. Is your dermatology practice struggling with billing and coding? If so, M-Scribe, LLC can help. We offer billing and coding services that can be customized to fit your needs. If you’re ready to boost your dermatology practice revenue for 2019, contact us today to learn more about how we can help.