Summary & Overview
CPT 1152F: Undocumented Clinical Measure
CPT code 1152F is listed without an available summary in the source material; it represents a clinical billing element or performance measure whose specific clinical intent is not provided. Nationally, any CPT code carries importance for clinical documentation, billing consistency, and payer coverage decisions. Missing or undocumented code descriptions can affect claims processing, quality reporting, and interoperability across electronic health record systems.
Key payers considered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of what is known about the code, which payers are relevant to national coverage discussions, and what information is missing from the source. The publication will also describe expected content areas typically addressed for CPT entries—such as service definition, typical site of service, and clinical context—and note where source data is unavailable.
This piece is intended to inform billing managers, revenue cycle professionals, and policy analysts about the presence of an undocumented CPT entry and the operational implications of incomplete coding metadata. Benchmarks, payer-specific coverage policies, and clinical mapping details are identified as topics that would normally follow when full code descriptions are available.
Billing Code Overview
CPT code 1152F has no summary available in the source description. Based on the available label, this code represents a clinical service or measure for which a concise summary was not provided.
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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.
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Description: No Summary found for this code
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to dermatology or outpatient surgical clinic with a suspicious skin lesion such as a rapidly changing pigmented lesion, non-healing ulcer, or lesion causing symptoms. The clinician performs a targeted skin biopsy (punch, shave, or excisional) to obtain tissue for histopathologic diagnosis. The workflow includes history and focused skin exam, informed consent, local anesthesia, lesion removal with appropriate technique and hemostasis, specimen labeling and submission to pathology, and brief wound care instructions. Procedure documentation includes lesion location, size, technique (e.g., punch or shave), anesthesia used, complications if any, and disposition. Typical sites of service are ambulatory surgery centers, hospital outpatient departments, and office-based dermatology clinics. Patient scenario example: a 62-year-old patient with a 7-mm irregular pigmented lesion on the forearm undergoes a punch biopsy under local anesthesia; tissue is sent for pathology to rule out melanoma or atypical nevi.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service | Use when an E/M service on the same day is above and beyond the procedure |
59 |