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Part 1 of 4
Paring or cutting of corns and calluses: 11055–11057
Paring is slicing away a benign hyperkeratotic lesion (a corn or callus) with a blade. The codes are chosen by how many lesions were pared, and you report only one of them per session.
| Code | Description |
|---|---|
11055 | Single lesion |
11056 | 2 to 4 lesions |
11057 | More than 4 lesions |
Three lesions is 11056, not 11057. Six lesions is 11057, once.
Removal of skin tags: 11200–11201
| Code | Description | Notes |
|---|---|---|
11200 | Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions | Report once |
+11201 | Each additional 10 lesions, or part thereof | Add-on |
| Tags removed | Codes |
|---|---|
| 14 | 11200 |
| 15 | 11200 |
| 16 | 11200 + 11201 |
| 25 | 11200 + 11201 |
| 26 | 11200 + 11201 × 2 |
Each 11201 covers up to 10 more tags. For 26 tags: 15 (11200) + 10 (11201) + 1 more (11201).
Done: Paring and skin tags
Part 2 of 4
Biopsy vs. removal
A biopsy removes only part of a lesion (or a small sample) and sends it to pathology to find out what it is. It is diagnostic, not a treatment. When the whole lesion is removed (by shaving or excision), it's a removal, coded from the shaving or excision codes instead.
Three techniques, six codes
| Technique | How it's done | Primary (first lesion) | Add-on (each extra lesion) |
|---|---|---|---|
| Tangential | Blade, shave, scoop, saucerize or curette; a partial-thickness sample (epidermis and dermis) | 11102 | +11103 |
| Punch | A punch tool removes a full-thickness cylinder of tissue | 11104 | +11105 |
| Incisional | A blade takes a full-thickness wedge (into subcutaneous fat) | 11106 | +11107 |
"Tangential" is the name of the technique. A note may say "shave biopsy," which is tangential.
One primary code per session
When different techniques are used, the primary code goes to the highest technique: incisional, then punch, then tangential. This matches the RVUs (the highest-valued procedure first), and CPT only allows these pairings:
| Add-on | May be reported with |
|---|---|
| +11103 (tangential) | 11102, 11104 or 11106 |
| +11105 (punch) | 11104 or 11106 |
| +11107 (incisional) | 11106 only |
So 11104 + 11106 on one claim is wrong: the second punch must be 11105. Add-on codes have no global period of their own and aren't cut by the multiple-procedure reduction (Claims Processing Manual ch. 12, §40.1).
Biopsy with other procedures
- Biopsy and removal of the same lesion at the same encounter: report only the removal. The biopsy is included (NCCI Policy Manual, ch. III).
- Biopsy of a different lesion than the one removed or destroyed: separately reportable, with 59 or XS when there's an NCCI edit (for example, the edits pairing 11102/11104/11106 with destruction codes 17000/17004).
- Local anesthesia by the physician is included.
Done: Biopsy techniques and codes
Part 3 of 4
Practice cases
Case 1 · paringThree plantar calluses paredOpen caseClose
Podiatrist pares three hyperkeratotic calluses on the left foot with a #15 blade.
Your turn: code this case
Case 2 · paringSix corns pared across both feetOpen caseClose
Six corns pared on both feet in one visit.
Your turn: code this case
Case 3 · skin tags26 skin tags removed from the neck and axillaeOpen caseClose
Snip removal of 26 fibrocutaneous skin tags.
Your turn: code this case
Case 4 · same techniqueTwo tangential (shave) biopsiesOpen caseClose
Shave biopsies of two separate lesions: right forearm and left upper back.
Your turn: code this case
Case 5 · same techniqueThree punch biopsiesOpen caseClose
4 mm punch biopsies of three separate lesions on the trunk.
Your turn: code this case
Case 6 · mixed techniquesIncisional, tangential and punch on three lesionsOpen caseClose
Lesion 1: incisional biopsy. Lesion 2: tangential biopsy. Lesion 3: punch biopsy.
Your turn: code this case
Case 7 · mixed techniquesOne punch and two tangential biopsiesOpen caseClose
Lesion 1: punch biopsy. Lesions 2 and 3: tangential biopsies.
Your turn: code this case
Done: Cases 1–7
Part 4 of 4
Case 8 · mixed techniquesTwo incisional biopsies and one punchOpen caseClose
Lesions 1 and 2: incisional biopsies. Lesion 3: punch biopsy.
Your turn: code this case
Case 9 · mixed techniquesOne incisional and two punch biopsiesOpen caseClose
Lesion 1: incisional biopsy. Lesions 2 and 3: punch biopsies.
Your turn: code this case
Case 10 · mixed techniquesOne incisional and two tangential biopsiesOpen caseClose
Lesion 1: incisional biopsy. Lesions 2 and 3: tangential biopsies.
Your turn: code this case
Case 11 · biopsy then excision, same lesionShave biopsy, frozen section, then excision of the same lesionOpen caseClose
A suspicious lesion on the back is shave biopsied, then excised the same day (malignant, excised diameter 1.8 cm).
Your turn: code this case
Case 12 · biopsy plus destruction, different lesionsPunch biopsy of one lesion, cryotherapy of an actinic keratosis elsewhereOpen caseClose
Punch biopsy of a pigmented lesion on the left cheek, and liquid nitrogen destruction of one actinic keratosis on the right hand. NCCI pairs 11104 with 17000.
Your turn: code this case
Case 13 · biopsy or removal?Irritated 0.4 cm seborrheic keratosis shaved off the forearmOpen caseClose
Assessment: irritated seborrheic keratosis, catching on clothing. Plan: remove. The entire 0.4 cm lesion on the forearm is removed by shave, flush with the skin, and sent to pathology.
Your turn: code this case
Case 14 · anesthesiaLidocaine injection before a punch biopsyOpen caseClose
1% lidocaine injected, then a punch biopsy of one lesion.
Your turn: code this case
Done: Cases 8–14