Summary & Overview
CPT 1151F: Performance Measure Entry (No Summary Provided)
CPT code 1151F is a CPT Category II-style alphanumeric code used for reporting a performance or quality measure; however, the input provides no descriptive summary of the measure itself. Nationally, such codes are important for capturing clinical quality metrics, informing value-based payment models, and supporting quality reporting across payers and Medicare. This publication focuses on the national relevance of CPT code 1151F, noting common payers and the kinds of benchmarks and policy context readers typically expect for performance-measure codes.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the code’s purpose, typical contexts where performance-measure codes are used, and the types of content that usually accompany such codes (reporting benchmarks, claims handling guidance, and links to policy updates). Where specific data was not provided in the source, the text notes the absence and signals areas where payers and providers typically supply guidance.
The report helps readers understand the clinical and administrative role of CPT code 1151F, what to look for in payer policies, and what benchmark and reporting elements are typically relevant for quality-measure codes.
Billing Code Overview
CPT code 1151F represents a performance measure entry with no summary provided in the input. Based on the code pattern and absence of a descriptive summary, the service type and typical site of service are not specified in the source data.
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Service Type: Data not available in the input.
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Typical Site of Service: Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult referred to a dermatology clinic for evaluation and management of a suspicious pigmented lesion on the trunk. The patient reports a changing mole with intermittent bleeding and irregular borders. The clinician performs a focused skin examination, documents lesion size, morphology, and location, and discusses risks and benefits of excisional biopsy versus shave or punch biopsy. In the clinic exam room, local anesthesia (e.g., lidocaine with epinephrine) is administered, and the lesion is removed with appropriate margin using an excisional technique. The specimen is labeled and sent to pathology with a requisition form that includes clinical history and suspected diagnosis. Post-procedure, the wound is closed (primary closure, layered if needed), dressings applied, and aftercare instructions provided. Follow-up is scheduled to review pathology results and determine need for further definitive treatment if malignancy is confirmed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Day of a Procedure | Use when a distinct E/M visit is provided on the same day as the procedure and is medically necessary and documented. |
57 |