When do I report a site-specific biopsy code instead of 11100?

Answer:  CPT® code 11100 is not specific for a lesion at a specific location. The code description specifies, “unless otherwise listed,” therefore, use this code only when your dermatologist takes a biopsy from a site for which CPT® doesn’t have a more specific code.

The good news is that site-specific codes represent procedures with higher relative value units (RVUs) on the Medicare Physician Fee Schedule, which means higher payment. Therefore, in addition to coding correctly, there’s a financial benefit to reporting the most specific code for the biopsy site.