October 9, 2025
Skin biopsies are one of the most common dermatological procedures, used to diagnose skin cancers, suspicious moles, or chronic skin conditions.Β
But the clinical process is straightforward; the medical billing and coding side can get complex. Using the correct CPT code for skin biopsy ensures compliance, prevents denials, and supports accurate reimbursement.
The main CPT codes for skin biopsy are:
Skin biopsy coding depends on the technique (shave/tangential vs punch) and the number of lesions biopsied.
Hereβs a quick comparison to avoid coding errors:
Procedure | Primary CPT Code | Add-On Code | Notes |
Tangential/Shave biopsy | 11102 | +11103 | Surface removal for diagnosis |
Punch biopsy | 11104 | +11105 | Includes simple closure, if performed |
Excisional biopsy (skin lesion removal) | 11400β11646 | N/A | Used when the entire lesion is excised |
Mole excision | 11400β11446 | N/A | Code depends on lesion size & location |
Tip: Biopsy = for diagnosis. Excision = therapeutic removal.
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A skin biopsy is a minor procedure where a doctor removes a small sample of skin for laboratory testing. It helps diagnose conditions like skin cancer, infections, or inflammatory skin diseases. Different techniques are used depending on the lesionβs size, depth, and suspected diagnosis.
Payers reimburse biopsy codes at different rates depending on lesion type and complexity:
Without proper documentation, claims risk denial or downcoding.
Correct use of CPT codes for skin biopsy (11102β11105) ensures providers are reimbursed fairly while staying compliant. The difference between biopsy vs excision codes, and when to apply modifier 59, can determine whether a claim is paid or denied.
Cures Medical Billing experts help dermatologists, surgeons, and primary care providers submit clean claims for skin procedures. From coding audits to denial management, we make sure you get paid for every service delivered.
Contact us today to simplify your biopsy and excision billing process.
The primary CPT code is 11104 for the first lesion, with 11105 for each additional lesion.
Use 11102 for the first lesion and 11103 for each additional shave biopsy lesion.
Mole excisions fall under skin lesion excision codes (11400β11646), not biopsy codes.
Yes, but only if they are performed on different lesions. Use modifier 59 to indicate separate procedures.
Append modifier 59 if different biopsy techniques (shave + punch) or biopsy plus excision are performed during the same encounter.
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