Coding and Billing

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The appropriate way to code and bill for the skin surgery is found below.

• For appropriate skin surgery coding and billing, first determine the probable diagnosis of the lesion that was biopsied or removed. It is important to note whether the lesion is pre-malignant, potentially malignant, or malignant because billing codes and fees differ depending on the diagnosis.

• Anatomical location and size are also important to record.

Below are the CPT codes for the skin surgery procedures and the details needed for billing.

Punch Biopsy

• The code for Punch Biopsy is CPT 11100. This is used for a single skin biopsy regardless of technique.

Shave Excision

• The code for Shave Excision depends on the anatomical location of the lesion and its size ( <0.5cm to > 2.0cm )

  • Trunk, arms or legs: CPT 11300-11303

  • Scalp, neck, hands, feet, or genitalia: CPT 11305-11308

  • Face, ears, eyelids, nose, lips, and mucus membranes: 11310-11313

• The billing form allows you to document the anatomical location and lesion size

Elliptical Excision

• The code for Elliptical Excision depends on the anatomical location of the lesion, its excised diameter (< 0.5cm to > 4.0cm), and whether it is benign or malignant. The excised diameter of the lesion is the diameter of the lesion plus two times the necessary margin to remove it safely and should be recorded as the "size" of the lesion.

  • Benign lesions: 11400-11446

  • Malignant lesions: 11600-11646 for malignant lesions

• The billing form has places to document location, size, and malignancy potential

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