Cracking the Code

Coding Multiple Biopsies

When multiple biopsy techniques are performed during the same encounter, it is important to understand the guidance pertaining to proper sequencing of the CPT codes. It is appropriate to only report ONE primary lesion biopsy CPT code (11102, 11104, or 11106). Additional biopsy codes should be assigned as well as proper add-on codes. Incisional biopsies take precedence over punch and tangential biopsy procedures. When reporting these three procedures, coders should report CPT 11106 first for the primary incisional biopsy. CPT 11105 or 11103 should be reported secondly as additional add-on codes.

Reference: References: AHA Coding Clinic for HCPCS First Quarter 2019, pages 1-4: Biopsy code changes
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