How To Use CPT Code 11900

CPT 11900 is an intralesional injection procedure code for treating up to and including 7 lesions. This article will cover the description, procedure, qualifying circumstances, when to use, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 11900.

1. What is CPT 11900?

CPT 11900 is a medical procedure code used to describe an intralesional injection of a corticosteroid, such as triamcinolone acetonide, for the treatment of large nodules, keloids, lichenified hyperkeratotic lesions, and numerous other conditions. This code is specifically used for the injection of up to 7 lesions.

2. 11900 CPT code description

The official description of CPT code 11900 is: “Injection, intralesional; up to and including 7 lesions.”

3. Procedure

1. The physician selects the appropriate corticosteroid, such as Kenalog or Aristocort, for the intralesional injection.
2. The physician cleans the area around the lesion(s) with an antiseptic solution.
3. A 25- or 30-gauge needle is inserted into the lesion.
4. The corticosteroid is injected into the lesion, causing the tissue to expand and fill with the fluid.
5. The needle is removed once the tissue has expanded.
6. This process is repeated for each lesion, up to a maximum of 7 lesions.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 11900 services are those with large nodules, keloids, lichenified hyperkeratotic lesions, and other conditions that can be treated with intralesional corticosteroid injections. The physician must determine that the patient’s condition warrants the use of this procedure and that the patient is not contraindicated for corticosteroid injections. Contraindications may include allergies to corticosteroids, active infections, or other medical conditions that could be exacerbated by corticosteroid injections.

5. When to use CPT code 11900

It is appropriate to bill the 11900 CPT code when a physician performs an intralesional injection of a corticosteroid for the treatment of up to and including 7 lesions. The physician must determine that the patient’s condition warrants the use of this procedure and that the patient is not contraindicated for corticosteroid injections.

6. Documentation requirements

To support a claim for CPT 11900, the following information should be documented in the patient’s medical record:

• Patient’s medical history and physical examination findings
• Diagnosis and indication for the intralesional injection
• Number of lesions treated (up to and including 7)
• Type and dosage of corticosteroid used
• Site(s) of injection
• Physician’s assessment of the patient’s response to the treatment
• Any adverse reactions or complications
• Follow-up care instructions and plan

7. Billing guidelines

When billing for CPT code 11900, it is important to follow the appropriate guidelines and rules. Some tips for billing this code include:

• Ensure that the patient’s medical record contains the necessary documentation to support the claim, as outlined in the documentation requirements section.
• Verify that the patient’s insurance plan covers the procedure and obtain any necessary pre-authorizations.
• Bill the appropriate number of units for the number of lesions treated, up to a maximum of 7.
• Include any relevant modifiers, such as -RT or -LT for right or left side, if applicable.

8. Historical information

CPT 11900 was added to the Current Procedural Terminology system on January 1, 1990. The code was changed on January 1, 2008, with the previous descriptor being “Injection, intralesional; up to and including seven lesions.”

9. Similar codes to CPT 11900

Five similar codes to CPT 11900 and how they differentiate are:

1. CPT 11901: This code is used for intralesional injections for more than 7 lesions.
2. CPT 96372: This code is used for therapeutic, prophylactic, or diagnostic injections, not intralesional.
3. CPT 20600: This code is used for arthrocentesis, aspiration, and/or injection of a small joint or bursa.
4. CPT 20605: This code is used for arthrocentesis, aspiration, and/or injection of an intermediate joint or bursa.
5. CPT 20610: This code is used for arthrocentesis, aspiration, and/or injection of a major joint or bursa.

10. Examples

Here are 10 detailed examples of CPT code 11900 procedures:

1. A patient with multiple keloids on the chest receives intralesional corticosteroid injections in 5 lesions.
2. A patient with 3 large nodules on the face receives intralesional corticosteroid injections in each nodule.
3. A patient with lichenified hyperkeratotic lesions on the arms receives intralesional corticosteroid injections in 7 lesions.
4. A patient with 6 hypertrophic scars on the back receives intralesional corticosteroid injections in each scar.
5. A patient with multiple prurigo nodules on the legs receives intralesional corticosteroid injections in 4 lesions.
6. A patient with 2 granuloma annulare lesions on the hands receives intralesional corticosteroid injections in each lesion.
7. A patient with 7 alopecia areata patches on the scalp receives intralesional corticosteroid injections in each patch.
8. A patient with multiple sarcoidosis lesions on the face receives intralesional corticosteroid injections in 5 lesions.
9. A patient with 3 hypertrophic lichen planus lesions on the arms receives intralesional corticosteroid injections in each lesion.
10. A patient with multiple psoriatic plaques on the legs receives intralesional corticosteroid injections in 6 lesions.