2025 CPT code 11106
(Active) Effective Date: N/A Revision Date: N/A Surgery - Biopsy Integumentary System Feed
Incisional biopsy of skin (e.g., wedge), single lesion, including simple closure when performed.
Modifiers may apply depending on the circumstances of the procedure and should be used according to the CPT guidelines. For example, modifier 59 may be appropriate if the biopsy is a distinct procedure from other services provided.
An incisional biopsy is medically necessary when the lesion is large, deep, or requires evaluation of deeper tissue structures beyond the reach of other biopsy techniques such as tangential or punch biopsy. The tissue is needed to make an accurate diagnosis and determine an appropriate treatment strategy.
The physician or qualified healthcare professional performs the procedure, including prepping the area, administering local anesthesia, making the incision, removing the tissue sample, and potentially closing the wound. They also send the specimen to the pathology lab for analysis.
In simple words: The doctor takes a sample of skin from a lesion using a small cut to check it under a microscope. This is done for larger or deeper skin problems.
Incisional biopsy of skin, which involves removing a full-thickness tissue sample via a vertical incision or wedge, penetrating deep to the dermis into the subcutaneous space.The intent is to obtain a tissue sample for diagnostic pathologic examination. Simple closure is included but not separately reported.This may sample subcutaneous fat, such as in panniculitis evaluation. For complete lesion excision with margins, refer to codes 11400-11646.
Example 1: A patient presents with a large, suspicious-looking mole on their back. The physician performs an incisional biopsy to remove a portion of the mole for pathological examination to determine if it is cancerous., A patient has a deep, inflamed nodule on their leg. The physician performs an incisional biopsy to evaluate the tissue for signs of infection or other underlying conditions such as panniculitis., A patient has a recurrent skin lesion that is not fully excised previously. The physician performs an incisional biopsy for the analysis of the lesion and possible cancerous changes.
** The selection of the appropriate biopsy technique should be determined by clinical judgment based on the type and location of the lesion and the diagnostic information needed.
- Revenue Code: P6C (Medicare Fee Schedule: MINOR PROCEDURES - OTHER)
- RVU: This information is not available in the provided text.Consult the current CPT codebook or a relevant medical billing resource for RVU data.
- Global Days: This information is not available in the provided text. The global period will depend on factors not specified here.Consult the current CPT codebook for guidance.
- Payment Status: Active
- Modifier TC rule: A Technical Component (TC) modifier is not typically applicable to this code as it represents the entire procedure.
- Fee Schedule: This information is not available in the provided text.Consult a relevant fee schedule database for historical fee data.
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center