Summary & Overview

CPT 11102: Tangential (Shave) Biopsy of Single Skin Lesion

CPT code 11102 denotes a tangential (shave) biopsy of a single skin lesion, a common diagnostic procedure used to remove superficial skin growths for histopathologic evaluation. Nationally, shave biopsies are routine across dermatology and primary care settings and affect utilization, documentation, and coding practices for skin lesion workups. Coverage, coding edits, and payment policies for shave biopsies influence outpatient surgical workflows and pathology referral patterns.

Key payers examined include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise briefing on payer coverage considerations, common billing relationships to related codes, and the clinical context in which 11102 is typically reported. The publication outlines benchmarks and policy-relevant points such as when shave biopsy is the appropriate technique versus other biopsy types and how that status translates into coding and claim submission.

This overview equips revenue cycle, clinical billing, and compliance teams with the essentials: what CPT code 11102 represents, where it is normally performed, and which national payers are relevant to its reimbursement and administrative handling. Data not available in the input for specific regional policies or payer-specific fee schedules.

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Billing Code Overview

CPT code 11102 describes a tangential (shave) biopsy of a single skin lesion. The procedure involves shaving off or scooping out the lesion with a knife or curette using a side-ways approach to obtain tissue for diagnostic evaluation.

Service type: Skin biopsy — tangential/shave technique

Typical site of service: Office or outpatient dermatology clinic

Clinical & Coding Specifications

Clinical Context

A 58-year-old patient presents to a dermatology clinic with a 6-mm raised, flesh-colored papule on the right lower eyelid noted to have slow growth over months. The clinician performs a focused history and targeted skin examination, documents lesion characteristics (size, location, color, depth, and symptoms), and obtains informed consent for a tangential (shave) biopsy. Local anesthesia (e.g., 1% lidocaine with epinephrine) is administered. Using a scalpel or curette, the clinician performs a tangential shave to remove the superficial portion of the lesion for histopathologic diagnosis. The specimen is placed in formalin, labeled, and sent to pathology; procedure details, estimated blood loss, and wound care instructions are documented. Typical sites of service include an outpatient dermatology clinic, family medicine office, or ambulatory surgical center. The service type is a minor skin surgical procedure (tangential/shave biopsy) for diagnostic evaluation of a cutaneous lesion. Typical clinical workflow includes pre-procedure assessment, local anesthetic administration, biopsy, specimen handling, immediate wound care, and post-procedure patient instructions and pathology follow-up.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure	Use when a distinct E/M visit is documented in addition to the biopsy (e.g., initial evaluation with medical decision-making separate from the biopsy).

Taxonomy Code	Specialty	Notes
`207N00000X`	Dermatology	Dermatologists commonly perform shave biopsies for diagnostic evaluation of cutaneous lesions.
`207Q00000X`	Family Medicine	Family physicians perform shave biopsies in office settings for common skin lesions.
`207R00000X`	Internal Medicine	General internists may perform shave biopsies when trained and credentialed.

ICD-10 Code	Description	Clinical Relevance
`D23.111`	Other benign neoplasm of skin of right upper eyelid, including canthus	Benign eyelid lesion that may be sampled with a tangential shave biopsy for diagnosis.
`D23.112`	Other benign neoplasm of skin of right lower eyelid, including canthus	Benign lower eyelid lesion appropriate for shave biopsy when superficial sampling is sufficient.
`D23.121`	Other benign neoplasm of skin of left upper eyelid, including canthus	Left upper eyelid benign lesion often evaluated with shave biopsy for histology.
`D23.122`	Other benign neoplasm of skin of left lower eyelid, including canthus	Left lower eyelid benign lesion that may be managed diagnostically with a shave biopsy.

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