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

CPT 11101 is the billing code for "Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), unless otherwise listed; each separate/additional lesion". Each additional separate biopsy of skin, subcutaneous tissue, or mucous membrane lesion

CPT 11101 has a total RVU of 1.14, broken down as: Work RVU 0.50, Practice Expense RVU 0.60, and Malpractice RVU 0.04. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 11101 include: Each additional lesion location documented; Method of biopsy documented; Specimens 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 11101: Add-on code for additional lesions. Must be preceded by 11100 Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 11101 include: 59 (Distinct procedural service when multiple procedures performed), 50 (Bilateral procedure). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

The typical time requirement for CPT 11101 is Typically 10-15 minutes per additional lesion. Time-based codes require documentation of the actual time spent providing the service.