How To Use cpt 11105

cpt 11105 describes the punch biopsy of skin, including simple closure, when performed, for each separate or additional lesion. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of cpt 11105.

1. What is cpt 11105?

cpt 11105 is a code used to describe the punch biopsy of skin, including simple closure, when performed, for each separate or additional lesion. This procedure involves the removal of a small portion of tissue from a suspicious skin lesion for pathological analysis. The code should be reported for each separate or additional lesion in addition to the primary procedure code.

2. Official Description

The official description of cpt 11105 is: ‘Punch biopsy of skin (including simple closure, when performed) each separate/additional lesion (List separately in addition to code for primary procedure).’ This code should be reported in conjunction with other biopsy technique codes when different biopsy techniques are used to sample separate or additional lesions.

3. Procedure

1. The provider prepares and anesthetizes the patient, typically using local anesthesia.
2. After performing a punch biopsy of an initial skin lesion, the provider stretches the skin containing another suspicious lesion perpendicular to resting skin lines to change its shape from round to oval.
3. The provider selects a punch size based on the size of the lesion, typically ranging from 3 to 5 mm.
4. Using their thumb and middle finger to support and rotate the punch, and their index finger to stabilize and exert pressure, the provider pushes the punch into the skin until they feel the resistance give way, indicating that they have reached the subcutaneous tissue.
5. The provider removes the biopsy specimen and may close the tissue with a suture or allow the wound to heal by secondary intention if the area has good vascularization.
6. The biopsy specimen is sent to the pathology lab for analysis.

4. Qualifying circumstances

cpt 11105 is performed on patients with suspicious skin lesions that require biopsy for pathological analysis. It is important to note that this code should be used for each separate or additional lesion, in addition to the primary procedure code. The provider may use different biopsy techniques to sample separate or additional lesions, and in such cases, cpt 11105 should be reported along with the appropriate codes for each technique used.

5. When to use cpt code 11105

cpt 11105 should be used when the provider performs a punch biopsy of skin, including simple closure, for each separate or additional lesion. This code should be reported for each lesion that requires biopsy, in addition to the primary procedure code. It is important to accurately document and report the number of separate or additional lesions biopsied.

6. Documentation requirements

To support a claim for cpt 11105, the provider must document the following information:

• Patient’s diagnosis and the need for biopsy
• Number of separate or additional lesions biopsied
• Details of the punch biopsy procedure, including the size of the punch used
• Method of closure, if performed
• Whether the wound is allowed to heal by secondary intention or closed with a suture
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for cpt 11105, ensure that the procedure is performed for each separate or additional lesion. This code should be reported in addition to the primary procedure code. If different biopsy techniques are used to sample separate or additional lesions, cpt 11105 should be reported along with the appropriate codes for each technique. It is important to follow the specific guidelines provided by the payer and accurately document the services performed.

8. Historical information

cpt 11105 was added to the Current Procedural Terminology system on January 1, 2019. There have been no updates to the code since its addition.

9. Similar codes to cpt 11105

Five similar codes to cpt 11105 include:

• cpt 11104: Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), unless otherwise listed; single lesion
• cpt 11106: Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), unless otherwise listed; each separate/additional lesion (List separately in addition to code for primary procedure)
• cpt 11102: Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); single lesion
• cpt 11103: Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); each separate/additional lesion (List separately in addition to code for primary procedure)
• cpt 11107: Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), unless otherwise listed; each additional lesion (List separately in addition to code for primary procedure)

9. Examples

1. A dermatologist performs a punch biopsy of a suspicious skin lesion on the patient’s arm.
2. A plastic surgeon performs a punch biopsy of two separate suspicious skin lesions on the patient’s face.
3. An oncologist performs a punch biopsy of a suspicious skin lesion on the patient’s back, and another separate lesion on their leg.
4. A family physician performs a punch biopsy of a suspicious skin lesion on the patient’s chest, and another separate lesion on their abdomen.
5. A dermatopathologist performs a punch biopsy of a suspicious skin lesion on the patient’s scalp, and another separate lesion on their neck.
6. A general surgeon performs a punch biopsy of a suspicious skin lesion on the patient’s hand, and another separate lesion on their foot.
7. An otolaryngologist performs a punch biopsy of a suspicious skin lesion on the patient’s ear, and another separate lesion on their nose.
8. A pediatrician performs a punch biopsy of a suspicious skin lesion on the patient’s leg, and another separate lesion on their arm.
9. A pathologist performs a punch biopsy of a suspicious skin lesion on the patient’s shoulder, and another separate lesion on their hip.
10. A plastic surgeon performs a punch biopsy of a suspicious skin lesion on the patient’s buttock, and another separate lesion on their thigh.