Podiatry Coding & Billing Alert

Answer: You should report 11106 (Incisional biopsy of skin (eg, wedge) (including simple closure, when performed); single lesion) on your claim.

Incisional biopsies involve removal of a larger and deeper amount of skin — a full-thickness sample of tissue penetrating deep to the dermis, into the subcutaneous space — which typically requires the use of a scalpel and involves a more complex closure.

When a physician performs an incisional biopsy, he must use a sharp blade, not a punch tool. Additionally, he will use a vertical incision or wedge to remove a full-thickness sample of tissue, according to the guidelines. The physician must go deep into the patient’s dermis, into the subcutaneous space.

Important: Incisional biopsies may sample subcutaneous fat, and the guidelines offer the example of biopsies that physicians perform to evaluate panniculitis. Additionally, although physicians might also perform closure along with incisional biopsies, you should not report simple closure separately, the guidelines reiterate.