Use 11100-11101 for specimens You can avoid denials the next time you report the internist's biopsy services if you follow the new CPT instructions that specify which codes you shouldn't bill with 11100 and 11101. New Instructions Clarify Bundles CPT 2004 introduces instructional notes under the Biopsy section that tell you when and how often to use codes 11100 (Biopsy of skin, subcutaneous tissue and/or mucous membrane [including simple closure], unless otherwise listed; single lesion) and +11101 (... each separate/additional lesion [list separately in addition to code for primary procedure]), says Laurie Castillo, MA, CPC, CPC-H, CCS-P, president of Professional Coding and Compliance Consulting in Manassas, Va., during her presentation on CPT 2004 changes at the Third Annual Coding, Billing, and Compliance Essentials Conference in Orlando, Fla.
Previously, CPT didn't provide instructions, and coders relied on the codes' descriptors and payer guidelines when reporting 11100 and 11101. The new instructional notes clarify that you shouldn't report 11100 and 11101 with other excision and biopsy codes, Castillo tells Internal Medicine Coding Alert.
The Biopsy section's guidelines include the following instructions: