{"id":180172,"date":"2026-08-17T06:03:27","date_gmt":"2026-08-17T06:03:27","guid":{"rendered":"https:\/\/pabau.com\/?p=180172"},"modified":"2026-08-18T12:03:21","modified_gmt":"2026-08-18T12:03:21","slug":"cpt-code-11103","status":"publish","type":"post","link":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-11103\/","title":{"rendered":"CPT Code 11103: Tangential skin biopsy billing guide 2026"},"content":{"rendered":"\n<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"MedicalWebPage\",\"headline\":\"CPT Code 11103: Tangential skin biopsy billing guide 2026\",\"description\":\"CPT Code 11103 (tangential biopsy, each additional lesion) billing guide covering modifiers, reimbursement rates, documentation requirements, and ICD-10 pairings.\",\"url\":\"https:\/\/pabau.com\/procedure-codes\/cpt-code-11103\/\",\"audience\":{\"@type\":\"MedicalAudience\",\"audienceType\":\"Clinician\"},\"reviewedBy\":{\"@type\":\"Person\",\"name\":\"Dr Vanja Kitanova\",\"jobTitle\":\"Medical Reviewer\",\"affiliation\":{\"@type\":\"Organization\",\"name\":\"Pabau\"},\"knowsAbout\":[\"Medical Coding\",\"Clinical Documentation\",\"Healthcare Billing\",\"Clinical Safety\"],\"sameAs\":\"https:\/\/pabau.com\/blog\/author\/vanja\/\"},\"datePublished\":\"2026-08-10\",\"dateModified\":\"2026-08-18\"}<\/script>\n\n\n        <div id=\"key_takeaways\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/12\/Key-Takeaways-Icon.svg\" alt=\"Key takeaways\" height=\"42\" width=\"42\">\n                                <h3>Key takeaways<\/h3>\n            <\/div>\n            <div class=\"list\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Specifically, CPT 11103 is an add-on code for each additional tangential skin biopsy lesion beyond the first.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Therefore, it cannot be billed without its primary code, CPT 11102, on the same claim.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Add-on codes are exempt from modifier 51, while modifiers 59 and XS separate distinct lesion sites.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Medicare pays less for 11103 than for 11102, so check current rates in the CMS fee schedule.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Ultimately, practice management software like Pabau keeps biopsy documentation and claim submission inside one patient record.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-what-cpt-11103-covers\" class=\"wp-block-heading\">What CPT 11103 covers<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT code 11103 describes a tangential biopsy of skin for each separate additional lesion beyond the first. Because it is an add-on code, it cannot be submitted without its parent code, CPT 11102. As a result, dermatology and primary care practices report this pair when a tangential biopsy covers more than one lesion in a single encounter.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-11103\/automate-claims-through-healthcode.webp\" alt=\"Automate claims and billing with Pabau\"\/><figcaption class=\"wp-element-caption\"><em>Pabau&#8217;s claims dashboard tracks every biopsy claim from submission to payment, so no 11103 line goes unpaid or unnoticed.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">In 2019, the American Medical Association replaced the old single biopsy code with three technique-specific pairs. As a result, CPT 11103 sits in the tangential pair alongside 11102. Code selection follows the technique documented in the note, so a shave, a punch, and an incisional biopsy each carry their own primary and add-on code.<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe title=\"CPT Coding Pitfalls Every Medical Practice Faces\" width=\"800\" height=\"450\" src=\"https:\/\/www.youtube.com\/embed\/vbvV5okdXKg?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<h2 id=\"h-official-descriptor-and-the-biopsy-code-family\" class=\"wp-block-heading\">Official descriptor and the biopsy code family<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The AMA rewrote this descriptor in 2019. Specifically, the current wording names the technique directly: &#8222;Tangential biopsy of skin (e.g., shave, scoop, saucerization, curettage); each separate\/additional lesion (List separately in addition to code for primary procedure).&#8220;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The instruction to list it separately is what most denials on this code come back to. Therefore, <a href=\"https:\/\/pabau.com\/industry\/dermatology-emr-software\/\">dermatology EMR software<\/a> that carries the parent code through to the claim keeps that pairing intact.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Type<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Technique<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Usage<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">11102<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Primary<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Tangential (shave)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">First lesion, always required<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">+11103<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Add-on<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Tangential (shave)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Each additional lesion, repeated as needed<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">11104<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Primary<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Punch<\/td>\n<td style=\"padding:12px 16px;color:#374151\">First lesion in a different technique family<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">+11105<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Add-on<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Punch<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Each additional punch lesion<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">11106<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Primary<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Incisional<\/td>\n<td style=\"padding:12px 16px;color:#374151\">First lesion taken full thickness<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">+11107<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Add-on<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Incisional<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Each additional incisional lesion<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Code selection depends on the biopsy technique, not the diagnosis. For example, a provider who shave-biopsies three lesions bills <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-11102\/\">11102<\/a> once and 11103 twice. If that provider also punch-biopsies a fourth lesion, it needs its own primary code, <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-11104\/\">11104<\/a>, and its own add-on chain.<\/p>\n\n\n\n<h2 id=\"h-what-is-a-tangential-biopsy\" class=\"wp-block-heading\">What is a tangential biopsy?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">A tangential biopsy removes tissue with a blade passed parallel to the skin surface. Consequently, it samples the epidermis and part of the superficial dermis, without creating a full-thickness wound. Practitioners still call it a shave biopsy, and the AMA&#8217;s 2019 wording also covers scoop and saucerization.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Recording the technique word for word matters more than it looks. That is why <a href=\"https:\/\/pabau.com\/industry\/skin-clinic-software\/\">skin clinic software<\/a> that pre-populates biopsy fields keeps the note and the code speaking the same language.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Technique<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Tissue depth<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Typical indication<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Primary code<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Tangential (shave)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Epidermis to superficial dermis<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Superficial lesions, suspected BCC, actinic keratosis<\/td>\n<td style=\"padding:12px 16px;color:#374151\">11102 \/ +11103<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Punch<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Full thickness, dermis to fat<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Suspected melanoma, inflammatory conditions<\/td>\n<td style=\"padding:12px 16px;color:#374151\">11104 \/ +11105<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Incisional<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Full thickness with scalpel incision<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Large lesions, subcutaneous sampling<\/td>\n<td style=\"padding:12px 16px;color:#374151\">11106 \/ +11107<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Choosing the wrong biopsy family is the most consequential error in this code set. If the note documents a shave but the claim reports 11104, the record and the code disagree. Consequently, that mismatch is exactly what payer audits look for.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Tangential biopsy is also easy to confuse with shave removal, which is a different code family entirely. For instance, removal codes such as <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-11302\/\">11302<\/a> and <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-11311\/\">11311<\/a> describe taking a lesion off, not sampling it. If the intent was removal rather than diagnosis, the biopsy codes do not apply.<\/p>\n\n\n\n<h2 id=\"h-cpt-11103-vs-11102-key-differences\" class=\"wp-block-heading\">CPT 11103 vs 11102: Key differences<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT 11102 reports the first tangential biopsy lesion and covers the baseline work. In contrast, CPT 11103 captures each later lesion taken by the same technique in the same encounter. Therefore, neither code carries the encounter on its own once multiple lesions are involved.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Feature<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">CPT 11102<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">CPT +11103<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code type<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Primary, stands alone<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Add-on, requires 11102<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Lesion count<\/td>\n<td style=\"padding:12px 16px;color:#374151\">First lesion only, billed once<\/td>\n<td style=\"padding:12px 16px;color:#374151\">One unit per additional lesion<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Modifier 51<\/td>\n<td style=\"padding:12px 16px;color:#374151\">May apply with other procedures<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Exempt, as all add-on codes are<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Technique<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Tangential shave or saucerization<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Same tangential technique<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Can bill alone?<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Yes<\/td>\n<td style=\"padding:12px 16px;color:#374151\">No, denied without 11102<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">When three tangential lesions are biopsied, the claim reads 11102 x 1 and 11103 x 2. In other words, the unit count for 11103 is always the total number of tangential lesions minus one.<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Count your tangential lesions before you submit. Bill 11102 once, then 11103 for every lesion above the first. For example, three lesions means 11102 x 1 and 11103 x 2. Document each biopsy site separately so the unit count is auditable.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-reimbursement-and-fee-schedule-for-2026\" class=\"wp-block-heading\">Reimbursement and fee schedule for 2026<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Reimbursement for CPT 11103 varies by setting, payer, and locality. Because it is an add-on code, its relative value units sit below those of the primary code. Therefore, the <a href=\"https:\/\/www.cms.gov\/medicare\/physician-fee-schedule\/search\/overview\" target=\"_blank\" rel=\"nofollow noopener\">CMS Physician Fee Schedule<\/a> lookup tool is the authoritative source for current Medicare rates by locality. Check it before you submit, because CMS updates the schedule every year.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Setting<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Approximate rate range<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Notes<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Non-facility (office)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">$38 to $55, estimated<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Verify in the CMS fee schedule, since rates vary by locality<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Facility (hospital or ASC)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Lower than non-facility<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Facility overhead is absorbed by the institution<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Private payer<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Varies by contracted rate<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Often a multiplier of Medicare, so check your remittance advice<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Important:<\/strong> The range above is an industry estimate built from aggregated fee schedule data. Actual Medicare payment depends on the 2026 conversion factor, the geographic practice cost indices, and the final CMS rule. Therefore, verify every rate through the CMS lookup before you submit.<\/p>\n\n\n\n<h2 id=\"h-modifiers-that-apply-to-cpt-11103\" class=\"wp-block-heading\">Modifiers that apply to CPT 11103<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Add-on codes follow modifier rules of their own. CPT 11103 sits in the AMA&#8217;s modifier 51 exempt list, so appending modifier 51 is incorrect and invites a rejection.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Modifier<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Name<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">When to use with 11103<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Common mistake<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">59<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Distinct procedural service<\/td>\n<td style=\"padding:12px 16px;color:#374151\">When payer edits bundle 11103 with another code, to show a separate lesion site<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Adding it when no edit exists<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">XS<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Separate structure<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Preferred over 59 where the payer accepts X modifiers<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Using 59 when the payer prefers XS<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">51<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Multiple procedures<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Never, because add-on codes are modifier 51 exempt<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Appending 51 to an add-on code<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Confirm modifier preferences with each payer before you submit. For instance, some commercial plans follow National Correct Coding Initiative edits closely and prefer the granular X modifiers over modifier 59. <a href=\"https:\/\/www.aapc.com\/codes\/cpt-codes-range\/\" target=\"_blank\" rel=\"nofollow noopener\">AAPC&#8217;s code lookup<\/a> shows which NCCI edits apply, which beats waiting for a denial to tell you.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Solid <a href=\"https:\/\/pabau.com\/blog\/hipaa-compliance-for-medical-offices\/\">HIPAA-compliant documentation<\/a> at the point of service also supports the modifier during a payer review. Specifically, the note has to show two anatomically distinct sites, not just two units on a claim line.<\/p>\n\n\n\n<h2 id=\"h-icd-10-codes-that-support-medical-necessity\" class=\"wp-block-heading\">ICD-10 codes that support medical necessity<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Medical necessity for a tangential biopsy rests on the diagnosis code attached to the claim. In other words, the diagnosis has to support the clinical rationale for taking tissue. Otherwise, a generic skin code with no documented suspicion invites a medical necessity denial. Therefore, a <a href=\"https:\/\/crosscoder.com\/\" target=\"_blank\" rel=\"nofollow noopener\">CPT-to-ICD-10 crosswalk tool<\/a> can confirm payer coverage policies before you submit.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">ICD-10-CM code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Clinical context<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">L57.0<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Actinic keratosis<\/td>\n<td style=\"padding:12px 16px;color:#374151\">A premalignant lesion and a common reason for tangential biopsy<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">D23.x<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Other benign neoplasm of skin<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Site-specific, so use the 4th and 5th characters for location<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">C44.x<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Other and unspecified malignant neoplasm of skin<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Suspected or confirmed, with the site named in the full code<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">L70.0<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Acne vulgaris<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Used when a biopsy rules out other diagnoses in an acne-like presentation<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">L98.9<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Disorder of skin and subcutaneous tissue, unspecified<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Use only when no more specific code can be assigned<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">These are commonly cited examples rather than an exhaustive medical necessity guide. Instead, payer local coverage determinations (LCDs) set out which ICD-10 codes support coverage for skin biopsies. Therefore, check the applicable determinations first, especially for Medicare Advantage plans that apply stricter criteria.<\/p>\n\n\n\n<h2 id=\"h-documentation-requirements\" class=\"wp-block-heading\">Documentation requirements<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Weak documentation is the second most common cause of 11103 denials, after incorrect pairing. Consequently, the procedure note has to stand on its own as justification for every lesion biopsied.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/pabau.com\/features\/patient-intake-software\/\">Digital intake forms<\/a> that capture biopsy-specific fields at the point of care keep that record complete. In turn, <a href=\"https:\/\/pabau.com\/blog\/medical-forms-at-your-healthcare-practice\/\">standardized medical forms<\/a> hold the format steady whichever provider performs the biopsy.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-11103\/medical-forms-new-medical-form-with-components-2x.webp\" alt=\"Building a new medical form with components in Pabau\"\/><figcaption class=\"wp-element-caption\"><em>Building a biopsy form in Pabau means technique, site, and specimen fields get captured while the patient is still in the room.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Biopsy technique documented:<\/strong> The note must state that a tangential or shave technique was used, not a generic biopsy performed. For example, a note that says punch biopsy cannot support 11103.<\/li>\n\n\n\n<li><strong>Site identification per lesion:<\/strong> Record each lesion&#8217;s anatomical location separately, such as right cheek or left forearm. However, a reference to multiple lesions does not substantiate multiple units.<\/li>\n\n\n\n<li><strong>Lesion count and size:<\/strong> Record how many lesions were biopsied and, where relevant, the approximate size of each one.<\/li>\n\n\n\n<li><strong>Specimen disposition:<\/strong> Note where each specimen went, such as pathology for histological examination, and track the specimen number against its lesion.<\/li>\n\n\n\n<li><strong>Clinical indication:<\/strong> Record why the biopsy was taken, whether that is a suspected diagnosis, a change in appearance, or a patient complaint.<\/li>\n\n\n\n<li><strong>Provider identity:<\/strong> Finally, the note must carry the name and credentials of the provider who performed the biopsy.<\/li>\n<\/ul>\n\n\n\n<h2 id=\"h-billing-multiple-lesions-in-one-encounter\" class=\"wp-block-heading\">Billing multiple lesions in one encounter<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The stacking rule is simple once the formula is clear. Report 11102 once for the primary lesion, then 11103 once for each additional tangential lesion. However, no ceiling applies to how many times 11103 can be reported in one encounter. Even so, each unit still needs its own documented lesion in the procedure note.<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Count the total tangential lesions biopsied during the encounter.<\/li>\n\n\n\n<li>Bill 11102 x 1 for the first lesion.<\/li>\n\n\n\n<li>Then bill 11103 for every lesion after the first.<\/li>\n\n\n\n<li>Finally, confirm each 11103 unit maps to a separately documented biopsy site.<\/li>\n\n\n\n<li>If a lesion in the same encounter was taken by punch, open 11104 as a new primary. Add <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-11105\/\">11105<\/a> for each further punch lesion.<\/li>\n<\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">Some payers apply quantity edits to 11103, flagging claims above four units for review. Therefore, when you bill high unit counts, send the records with the claim or expect a request for them.<\/p>\n\n\n\n<h2 id=\"h-common-billing-mistakes\" class=\"wp-block-heading\">Common billing mistakes<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Most 11103 denials trace back to a handful of repeatable errors. For example, <a href=\"https:\/\/pabau.com\/features\/compliance-management-software\/\">compliance management tools<\/a> catch them before submission rather than after the denial arrives, and a structured pre-submission check does the same job by hand.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Billing 11103 without 11102:<\/strong> The most common denial trigger. An add-on code cannot stand alone on a claim, so 11102 always leads when a tangential biopsy is performed.<\/li>\n\n\n\n<li><strong>Appending modifier 51:<\/strong> Add-on codes are modifier 51 exempt by AMA definition. As a result, appending it flags the claim for manual review and often ends in a reduction or a denial.<\/li>\n\n\n\n<li><strong>Wrong biopsy family:<\/strong> Billing 11103 when the note documents a punch technique creates a mismatch that surfaces in audits. In short, code selection follows the documented technique, not the intended one and not the diagnosis.<\/li>\n\n\n\n<li><strong>Unbundling with destruction codes:<\/strong> CPT 11103 generally cannot be billed with a destruction code such as <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-17000\/\">17000<\/a> for the same lesion in the same session. In other words, biopsy and destruction of one lesion are treated as bundled.<\/li>\n\n\n\n<li><strong>Missing lesion-specific documentation:<\/strong> Claiming several units of 11103 without separate site notes is a documentation failure rather than a coding one. Either way, the outcome is identical: a denial or a recoupment.<\/li>\n\n\n\n<li><strong>Incorrect ICD-10 pairing:<\/strong> A diagnosis that does not support the reason for the biopsy can trigger a medical necessity denial. That happens even when the CPT coding itself is correct.<\/li>\n<\/ul>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Run a monthly audit on your 11103 claim lines. Then pull every claim where 11103 appears without 11102 on the same date of service. Ideally, that list should come back empty. If it does not, your charge capture process is generating automatic denials.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-related-codes-for-skin-biopsy-procedures\" class=\"wp-block-heading\">Related codes for skin biopsy procedures<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT 11103 sits inside a wider set of skin procedure and pathology codes. Knowing the neighbors prevents cross-code errors and captures everything billable from a biopsy encounter. For example, the same primary-plus-add-on pattern turns up elsewhere in dermatology, including <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-11043\/\">11043<\/a> for debridement measured by area.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Relationship to 11103<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">11102<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Tangential skin biopsy, first lesion<\/td>\n<td style=\"padding:12px 16px;color:#374151\">The required primary code, always billed with 11103<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">11104<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Punch biopsy, first lesion<\/td>\n<td style=\"padding:12px 16px;color:#374151\">A different technique family, used when a punch is documented<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">+11105<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Punch biopsy, each additional lesion<\/td>\n<td style=\"padding:12px 16px;color:#374151\">The punch family add-on, never mixed with 11103<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">11106<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Incisional biopsy, first lesion<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Full-thickness technique, used when a scalpel incision is documented<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">+11107<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Incisional biopsy, each additional lesion<\/td>\n<td style=\"padding:12px 16px;color:#374151\">The incisional family add-on<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">88305<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Pathology exam, level IV<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Billed by the lab when the specimen goes for histological review<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">17110<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Destruction of benign lesions, up to 14<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Generally not billable with a biopsy of the same lesion<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<h2 id=\"h-how-pabau-supports-dermatology-biopsy-billing\" class=\"wp-block-heading\">How Pabau supports dermatology biopsy billing<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Dermatology practices billing tangential biopsy codes run a chain from the procedure note to the claim. Consequently, detail drops out at every handover. Pabau is an all-in-one <a href=\"https:\/\/pabau.com\/blog\/practice-management-software\/\">practice management system<\/a>, so the clinical note, the specimen record, and the invoice sit on one patient file.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">When a clinician records a tangential biopsy of three lesions, the billing team can see the technique, the lesion count, and where each specimen went. As a result, structured <a href=\"https:\/\/pabau.com\/features\/medical-records-management\/\">medical records<\/a> mean nobody reconstructs that from paper or a second system.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pabau&#8217;s <a href=\"https:\/\/pabau.com\/features\/claims-management-software\/\">claims management software<\/a> then runs a completeness check on each claim before it goes out. It confirms that the details insurers need, such as membership numbers and authorization codes, are present. However, it does not validate CPT pairings for you, so the add-on rules in this guide still sit with your coder.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For groups running several locations, one shared record structure keeps every provider&#8217;s biopsy documentation in the same format. As a result, that makes an audit response faster to assemble and easier to defend.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-11103\/automated-communication-in-pabau.webp\" alt=\"Automated patient communication in Pabau\"\/><figcaption class=\"wp-element-caption\"><em>Pabau&#8217;s automated messages keep patients updated after a biopsy, so your front desk is not fielding calls about results.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n        <div id=\"book_a_demo\">\n            <div class=\"left-side\">\n                <div class=\"logo\">\n                    <img decoding=\"async\"\n                        src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Logo.svg\"\n                        alt=\"Logo\"\n                        loading=\"lazy\"\n                    \/>\n                <\/div>\n\n                <h3 class=\"heading\">\n                    Keep biopsy notes and claims in one system                <\/h3>\n\n                <p class=\"description\">\n                    Pabau records biopsy technique, site, and specimen details in the patient file, then carries those details into the claim. Your billing team works from the clinical note instead of chasing it.                <\/p>\n\n                <div class=\"button-group\">\n                    <a href=\"\/book-demo\/\" class=\"btn btn-scale-effect btn-cta-color btn-md\">\n                        <span class=\"btn-text\">Book a demo<\/span>\n                        <div class=\"btn-icon btn-icon-right\" aria-hidden=\"true\">\n                            <svg\n                                width=\"14\"\n                                height=\"12\"\n                                viewBox=\"0 0 14 12\"\n                                fill=\"none\"\n                                xmlns=\"http:\/\/www.w3.org\/2000\/svg\"\n                            >\n                                <path\n                                    d=\"M0.75 4.77295C0.335786 4.77295 0 5.10874 0 5.52295C0 5.93716 0.335786 6.27295 0.75 6.27295V5.52295V4.77295ZM13.2803 6.05328C13.5732 5.76039 13.5732 5.28551 13.2803 4.99262L8.50736 0.219648C8.21447 -0.073245 7.73959 -0.073245 7.4467 0.219648C7.15381 0.512542 7.15381 0.987415 7.4467 1.28031L11.6893 5.52295L7.4467 9.76559C7.15381 10.0585 7.15381 10.5334 7.4467 10.8263C7.73959 11.1191 8.21447 11.1191 8.50736 10.8263L13.2803 6.05328ZM0.75 5.52295V6.27295L12.75 6.27295V5.52295V4.77295L0.75 4.77295V5.52295Z\"\n                                    fill=\"currentColor\"\n                                ><\/path>\n                            <\/svg>\n                        <\/div>\n                    <\/a>\n                <\/div>\n            <\/div>\n\n            <div class=\"right-side\">\n                <img decoding=\"async\"\n                    src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Home-Page-Concept-4.webp\"\n                    alt=\"Pabau dermatology practice management dashboard\"\n                    loading=\"lazy\"\n                \/>\n            <\/div>\n        <\/div>\n        \n\n\n<h2 id=\"h-conclusion\" class=\"wp-block-heading\">Conclusion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Get the pairing right and 11103 stops being a problem code. In short, the rules are few, and every one of them is settled before the claim leaves your practice.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The judgment worth keeping is that this is a documentation question dressed up as a billing one. Payers do not argue about whether 11103 exists. Instead, they argue about whether your note proves a second lesion was sampled by the same technique.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Fix the note and the claim takes care of itself. <a href=\"https:\/\/pabau.com\/book-demo\/\">Book a demo<\/a> to see how Pabau keeps biopsy documentation and claim submission on one patient record.<\/p>\n\n\n        <div id=\"expert_picks\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/11\/Expert-Picks.svg\" alt=\"Continue your research\" height=\"42\" width=\"42\">\n                                <h3>Continue your research<\/h3>\n            <\/div>\n            <div class=\"content\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Choosing software for a skin practice?<\/strong> <a href=\"https:\/\/pabau.com\/blog\/7-best-dermatology-ehr-software\/\">Best dermatology EHR software<\/a> compares the systems that handle clinical notes and insurance billing together.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Need the consent paperwork to match?<\/strong> <a href=\"https:\/\/pabau.com\/templates\/dermatology-consent\/\">Dermatology consent template<\/a> gives you a form patients can sign before a biopsy.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>New to insurance workflows?<\/strong> <a href=\"https:\/\/pabau.com\/blog\/what-is-medical-billing\/\">What is medical billing<\/a> walks through the path from invoice to payment.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Weighing up how to structure the practice?<\/strong> <a href=\"https:\/\/pabau.com\/blog\/group-practice-vs-private-practice\/\">Group vs private practice<\/a> sets out what changes for billing and staffing.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Want the intake side tightened up?<\/strong> <a href=\"https:\/\/pabau.com\/templates\/dermatology-intake-form\/\">Dermatology intake form<\/a> captures history and lesion concerns before the appointment starts.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-frequently-asked-questions\" class=\"wp-block-heading\">Frequently asked questions<\/h2>\n\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1786694242154\"><h3 class=\"schema-faq-question\">What is CPT Code 11103?<\/h3> <p class=\"schema-faq-answer\">CPT Code 11103 is an add-on billing code for the tangential biopsy of skin, covering each separate additional lesion beyond the first. Specifically, it must always be reported alongside CPT 11102, which covers the first tangential biopsy lesion. In other words, it cannot be billed as a standalone code.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786694242158\"><h3 class=\"schema-faq-question\">What modifiers apply to CPT Code 11103?<\/h3> <p class=\"schema-faq-answer\">Modifier 59 or modifier XS may be used when payer edits bundle 11103 with another procedure. In either case, both signal that the lesion sites are anatomically distinct. Modifier 51 should not be appended, because add-on codes like 11103 are modifier 51 exempt.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786694242159\"><h3 class=\"schema-faq-question\">What ICD-10 codes are commonly used with CPT 11103?<\/h3> <p class=\"schema-faq-answer\">Common ICD-10-CM codes paired with CPT 11103 include L57.0 for actinic keratosis, D23.x for benign skin neoplasms, and C44.x for malignant skin neoplasms. However, always check that the paired diagnosis meets the payer&#8217;s local coverage determination for skin biopsy.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786694242161\"><h3 class=\"schema-faq-question\">How much does Medicare reimburse for CPT 11103?<\/h3> <p class=\"schema-faq-answer\">Medicare reimbursement for CPT 11103 varies by locality and setting. For instance, non-facility office rates are generally higher than facility rates. Industry estimates place the non-facility rate between $38 and $55 for 2026, but those figures are estimates only. Therefore, verify current rates in the CMS Physician Fee Schedule lookup tool before you submit.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786694242162\"><h3 class=\"schema-faq-question\">Is 11103 the same as a shave removal code?<\/h3> <p class=\"schema-faq-answer\">No. Shave removal codes such as 11302 and 11311 report therapeutic removal of a lesion. In contrast, CPT 11103 reports a diagnostic sample taken by the same blade technique. The distinction is intent, and the note has to state it.<\/p> <\/div> <\/div>\n","protected":false},"excerpt":{"rendered":"<p>What CPT 11103 covers CPT code 11103 describes a tangential biopsy of skin for each separate additional lesion beyond the first. Because it is an add-on code, it cannot be submitted without its parent code, CPT 11102. As a result, dermatology and primary care practices report this pair when a tangential biopsy covers more than [&hellip;]<\/p>\n","protected":false},"author":84,"featured_media":180168,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_yoast_wpseo_linkdex":"80","_yoast_wpseo_content_score":"90","_yoast_wpseo_is_cornerstone":"","_yoast_wpseo_keywordsynonyms":"[\"\",\"\",\"\",\"\"]","_yoast_wpseo_focuskw_text_input":"","_seo_original_html":"","footnotes":""},"categories":[1433,1546],"tags":[1364,4126,1534,1600,1603],"class_list":["post-180172","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-billing-codes","category-cpt-codes","tag-billing","tag-cpt","tag-dermatology-billing","tag-dermatology-cpt-codes","tag-dermatology-documentation"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.2 (Yoast SEO v28.2) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>CPT Code 11103: Tangential skin biopsy billing guide 2026<\/title>\n<meta name=\"description\" content=\"CPT 11103 bills each additional tangential biopsy lesion with 11102. It\u2019s modifier 51 exempt and needs per-lesion notes.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-11103\/\" \/>\n<meta property=\"og:locale\" content=\"de_DE\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"CPT Code 11103: Tangential skin biopsy billing guide 2026\" \/>\n<meta property=\"og:description\" content=\"CPT 11103 bills each additional tangential biopsy lesion with 11102. 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However, always check that the paired diagnosis meets the payer's local coverage determination for skin biopsy.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-11103\/#faq-question-1786694242161","position":4,"url":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-11103\/#faq-question-1786694242161","name":"How much does Medicare reimburse for CPT 11103?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Medicare reimbursement for CPT 11103 varies by locality and setting. For instance, non-facility office rates are generally higher than facility rates. Industry estimates place the non-facility rate between $38 and $55 for 2026, but those figures are estimates only. Therefore, verify current rates in the CMS Physician Fee Schedule lookup tool before you submit.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-11103\/#faq-question-1786694242162","position":5,"url":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-11103\/#faq-question-1786694242162","name":"Is 11103 the same as a shave removal code?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"No. Shave removal codes such as 11302 and 11311 report therapeutic removal of a lesion. In contrast, CPT 11103 reports a diagnostic sample taken by the same blade technique. The distinction is intent, and the note has to state it.","inLanguage":"de"},"inLanguage":"de"}]}},"yoast":{"focus_keyword":"cpt code 11103","seo_title":"CPT Code 11103: Tangential skin biopsy billing guide 2026","meta_description":"CPT 11103 bills each additional tangential biopsy lesion with 11102. It\u2019s modifier 51 exempt and needs per-lesion notes.","content_score":"90","is_cornerstone":"","related_keyphrases":[{"keyword":"skin biopsy cpt code","score":72},{"keyword":"11102 cpt code","score":72},{"keyword":"cpt code 11103 modifiers","score":61}]},"_links":{"self":[{"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/posts\/180172","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/users\/84"}],"replies":[{"embeddable":true,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/comments?post=180172"}],"version-history":[{"count":5,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/posts\/180172\/revisions"}],"predecessor-version":[{"id":183862,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/posts\/180172\/revisions\/183862"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/media\/180168"}],"wp:attachment":[{"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/media?parent=180172"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/categories?post=180172"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/tags?post=180172"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}