Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), unless otherwise listed; single lesion

CPT 11100 is the billing code for "Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), unless otherwise listed; single lesion". Biopsy of single skin, subcutaneous tissue, or mucous membrane lesion

CPT 11100 has a total RVU of 1.66, broken down as: Work RVU 0.75, Practice Expense RVU 0.85, and Malpractice RVU 0.06. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 11100 include: Location of lesion documented; Method of biopsy documented; Specimen sent for pathology; Simple closure documented if performed. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 11100: Single lesion only. Use 11101 for each additional lesion Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 11100 include: 59 (Distinct procedural service when multiple procedures performed), 50 (Bilateral procedure), LT (Left side). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

The typical time requirement for CPT 11100 is Typically 10-20 minutes. Time-based codes require documentation of the actual time spent providing the service.