Under the new biopsy codes eff 1/1/19 (11102-11107) you need to bill the most intensive code and then each additional lesion biopsied is reported under add on codes
Pick one primary code from 11102, 11104, 11106. Add-on codes are 11103, 11105, 11107
TANGENTIAL and Punch should be billed as follows:
11104 PUNCH BIOPSY SKIN SINGLE LESION
11103 TANGENTIAL BIOPSY SKIN EA SEP/ADDITIONAL LESION
Then if shave removal
11301 is a separate lesion then bill line with modifier 59, if its same lesion as one of the other 2, the second biopsy is not separately reported