How To Use cpt 11107

cpt 11107 describes the incisional biopsy of skin, specifically for each additional or separate lesion. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of cpt 11107.

1. What is cpt 11107?

cpt 11107 is a code used to describe the incisional biopsy of skin for each additional or separate lesion. It is performed by a healthcare provider to remove a small portion of tissue from a lesion for pathological analysis. This code is used when multiple lesions require biopsy, in addition to the primary procedure.

2. Official Description

The official description of cpt 11107 is: ‘Incisional biopsy of skin (eg, wedge) (including simple closure, when performed) each separate/additional lesion (List separately in addition to code for primary procedure)’

3. Procedure

1. The healthcare provider prepares and anesthetizes the patient, typically with local anesthesia.
2. After performing an incisional biopsy of the first lesion, the provider incises the skin from the center of another lesion out to and including the normal surrounding skin margin.
3. A portion of the lesion is removed for pathological analysis.
4. If a wedge incisional biopsy is performed, a triangular or V-shaped incision is made using a scalpel blade to extract a wedge-shaped portion of tissue.
5. The provider may close the wound with a suture or allow it to heal by secondary intention if the area has good vascularization.
6. The specimen is sent to the pathology lab for analysis.

4. Qualifying circumstances

cpt 11107 is used when the provider performs an incisional biopsy on each additional or separate lesion, in addition to the primary procedure. This code is typically used for large or deep skin lesions that require biopsy. It is important to note that cpt 11107 should be reported in conjunction with cpt 11106.

5. When to use cpt code 11107

cpt 11107 should be used when the provider performs an incisional biopsy on each additional or separate lesion, in addition to the primary procedure. This code is used when multiple lesions require biopsy, and it should be reported for each additional/separate lesion in addition to the primary code cpt 11106.

6. Documentation requirements

To support a claim for cpt 11107, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for incisional biopsy
• Specific details of the procedure, including the number of lesions biopsied
• Date of the procedure
• Start and end time of the procedure
• Details of the incisional biopsy technique used
• Any closure performed, if applicable
• Information about the specimen sent to the pathology lab
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for cpt 11107, ensure that the provider performs an incisional biopsy on each additional or separate lesion, in addition to the primary procedure. This code should be reported in conjunction with cpt 11106. It is important to follow the specific guidelines provided by the payer regarding the use of modifiers and any additional documentation requirements.

8. Historical information

cpt 11107 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 11107

Five similar codes to cpt 11107 include:

• cpt 11106: This code is used for the primary incisional biopsy of skin.
• cpt 11102: This code is used for tangential biopsy procedures on the skin, such as shave, scoop, saucerize, or curette.
• cpt 11103: This code is used for each separate additional lesion when performing a tangential biopsy.
• cpt 11104: This code is used for punch biopsy of the skin for the initial lesion.
• cpt 11105: This code is used for each additional separate lesion when performing a punch biopsy.

9. Examples

1. A dermatologist performing an incisional biopsy on multiple separate skin lesions for pathological analysis.
2. A plastic surgeon removing a small portion of tissue from each additional lesion for further examination.
3. An oncologist performing an incisional biopsy on multiple separate skin lesions to determine the presence of cancer cells.
4. A general surgeon performing an incisional biopsy on multiple separate skin lesions to diagnose a skin condition.
5. A dermatopathologist analyzing multiple separate skin lesion samples obtained through incisional biopsy.
6. A dermatologist performing an incisional biopsy on multiple separate skin lesions to assess the extent of a disease.
7. A plastic surgeon removing a small portion of tissue from each additional lesion to determine the appropriate treatment plan.
8. An oncologist performing an incisional biopsy on multiple separate skin lesions to monitor disease progression.
9. A general surgeon performing an incisional biopsy on multiple separate skin lesions to rule out malignancy.
10. A dermatopathologist analyzing multiple separate skin lesion samples obtained through incisional biopsy to provide a definitive diagnosis.