10/26/2017

Correct Billing for a Shave Biopsy

I am being denied payment for a shave biopsy - being told that this code cannot be billed by a podiatrist. CPT - 11302. How can we fight this and/or is there another code that can be billed instead?

The denial reason is accurate because the code that was used, is the incorrect code for podiatry as 11302 is used for leg and considered to be out of scope of podiatry. 

Procedure Codes: 11300-11303-Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs

The more appropriate codes are listed below depending on the size of the lesion being shaved.

Procedure Code: 11305-Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less

Procedure Code: 11306-Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.6 to 1.0 cm

Procedure Code: 11307-Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 1.1 to 2.0 cm

Procedure Code: 11308-Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter over 2.0 cm