CPT 1136F: Undefined CPT Reporting Element

CPT code 1136F is a CPT system code with no summary provided in the source description. Nationally, clear definitions for CPT codes support consistent clinical documentation, quality reporting, and claims adjudication; a missing or undefined code description can create uncertainty for providers, payers, and billing teams. Key payers relevant to a national analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise statement of what is and is not available for this code, context about why a defined CPT description matters for billing and reporting, and guidance on where to look next for supplemental information. The publication outlines expected benchmarks and policy implications when code definitions are absent, summarizes the clinical and administrative impacts of an undefined CPT element, and identifies next steps for obtaining authoritative clarification from CPT publications or payer guidance. Data not provided in the input is explicitly noted where applicable.

Billing Code Overview

CPT code 1136F has no summary available in the source description. Based on the code designation, this entry represents a specific clinical or administrative reporting element within the CPT system. The available description field states: No Summary found for this code.

Service Type: Data not available in the input.

Typical Site of Service: Data not available in the input.

Clinical Context

A typical patient is an adult evaluated in dermatology or primary care for a suspicious skin lesion that may represent skin cancer (for example, a rapidly growing pigmented lesion, an indurated nodule, or a lesion with irregular borders). The clinician documents lesion history, performs a focused skin exam, counsels the patient about diagnostic options, and obtains informed consent for a biopsy or excision. The procedure is performed in an outpatient clinic or ambulatory surgery center under local anesthesia. Tissue is removed and submitted to pathology for histologic diagnosis. Wound closure is performed when indicated, and post-procedure instructions are provided. The encounter includes documentation of lesion location, size, technique used (shave, punch, or excisional), anesthesia, hemostasis, and specimen handling for pathology.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, Separately Identifiable Evaluation and Management Service on Same Day as Procedure	Use when a distinct E/M visit is provided on the same day as the procedure and documented separately.
`26`	Professional Component	Use when only the professional component of a diagnostic service is reported.

Taxonomy Code	Specialty	Notes
207Q00000X	Dermatology	Dermatologists commonly perform skin biopsies and excisions.
208000000X	Family Medicine	Family physicians perform skin lesion evaluations and minor procedures.
207R00000X	Dermatopathology	Dermatopathologists provide pathology interpretation of biopsy specimens.
363L00000X	General Surgery	General surgeons perform excisional procedures for suspicious lesions.
207K00000X	Plastic Surgery	Plastic surgeons perform complex excisions and reconstruction for lesions in cosmetically sensitive areas.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`D03.9`	Melanoma in situ, unspecified	Lesions suspicious for melanoma in situ may prompt biopsy or excision.
`C43.9`	Malignant melanoma of skin, unspecified	Biopsy/excision is performed to diagnose or definitively treat suspected melanoma.
`C44.9`	Malignant neoplasm of skin, unspecified	Non-melanoma skin cancers (squamous cell, basal cell) are diagnosed and treated with biopsy/excision.
`L57.0`	Actinic keratosis	Potentially premalignant lesions often sampled or treated; biopsies may be done if suspicious.
`L98.9`	Disorder of skin and subcutaneous tissue, unspecified	General code for unspecified skin lesions requiring diagnostic biopsy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`11102`	Tangential biopsy of skin (shave), single lesion; simple	Often used for superficial sampling of suspicious lesions prior to or instead of excision.
`11103`	Tangential biopsy of skin (shave), single lesion; with tissue orientation	Used for shave biopsies where specimen orientation is required for pathology.
`11104`	Tangential biopsy of skin (shave), single lesion; complicated	Used when shave biopsy requires more complex technique.
`11100`	Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), single lesion; a punch biopsy	Common alternative technique for sampling lesions of uncertain diagnosis.
`11600`	Excision, malignant lesion including margins, excision simple (0.5 cm or less)	Used when pathology confirms malignancy and a definitive excision with margins is performed.
`12001`	Repair, intermediate with simple or complex closure (simple repair codes vary by size)	Used for wound closures after biopsy or excision when layered closure is required.

OpenPayer

Summary & Overview