Summary & Overview
CPT 1160F: Clinical Service (Summary Not Available)
CPT code 1160F refers to a clinical service for which no summary was provided in the input. Nationally, billing codes without clear descriptions can create ambiguity in claims processing, utilization tracking, and payer-provider communication. This publication focuses on clarifying the code’s role where possible, outlining payer coverage considerations, and identifying gaps in publicly available metadata.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The content highlights where standard benchmarks and policy updates may apply and notes missing elements that affect comparative analyses.
Readers will find: a concise overview of what the code represents, the payers covered in this review, and a clear account of missing data elements. The report also outlines the types of benchmarks and policy updates that are typically relevant for CPT codes, and it provides clinical context where available. Where specific fields are not provided in the input, the publication explicitly indicates that data is not available, allowing readers to understand the limits of the current metadata.
Billing Code Overview
CPT code 1160F has no official summary available in the input. Based on the available description, this code represents a clinical service for which a concise summary was not provided. Service type: Data not available in the input. Typical site of service: Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult referred to dermatology for evaluation and management of a suspicious skin lesion or non-healing ulcer. The clinician performs a focused history and physical, documents lesion characteristics (size, location, depth, pigmentation, induration), and discusses procedural options. For an excisional or diagnostic skin procedure billed with 1160F, the workflow includes informed consent, aseptic preparation, local anesthesia administration, lesion excision or biopsy with appropriate margins, hemostasis, and specimen submission to pathology. Post-procedure instructions and wound care are provided, and the visit is documented with site, technique, extent of excision, and any complications. Typical sites of service include an outpatient dermatology clinic, ambulatory surgical center, or office-based procedure room. Common patient scenarios include evaluation of a suspected basal cell carcinoma, squamous cell carcinoma, melanoma in situ, or removal of a benign but symptomatic lesion for diagnostic confirmation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
95 | Synchronous telemedicine service rendered via real-time interactive audio and video telecommunications system | Use when the service is provided as live telemedicine in accordance with payer rules (if applicable to pre- or post-procedure telehealth visits) |
GT | Via interactive audio and video telecommunications system (telehealth) | Use when the service is furnished through a telecommunication system per payer policy |
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure | Use when an E/M visit is documented separately and supports a distinct decision-making process from the procedure |
26 | Professional component | Use when billing only the professional component of a diagnostic test or service that has a split global payment |
TC | Technical component | Use when billing only the technical component of a service (e.g., pathology technical processing billed by facility/lab) |
59 | Distinct procedural service | Use to indicate a procedure or service was distinct or independent from other services performed on the same day |
57 | Decision for surgery | Use on an E/M code when the visit resulted in the decision to perform surgery within the global period |
52 | Reduced services | Use when a service is partially reduced or eliminated at the physician’s discretion |
GA | Waiver of liability statement on file (patient refused/declined) | Use when a voluntary ABN or waiver is on file for items/services not reasonable and necessary per Medicare |
GZ | Item or service expected to be denied as not reasonable and necessary, no ABN on file | Use when the service is not reasonable and necessary and no ABN is obtained |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207Q00000X | Dermatology | Dermatologists most commonly perform skin excisions, biopsies, and related procedures |
| 208D00000X | General Practice | Primary care physicians perform skin lesion evaluations and minor excisions in office settings |
| 2080P0207X | Family Medicine | Family medicine physicians commonly perform office-based lesion excisions and biopsies |
| 207SG0200X | Dermatopathology | Dermatopathologists receive and interpret submitted skin specimens; integral to diagnosis |
| 261QM0800X | Plastic Surgery | Plastic surgeons perform excisions and closures for lesions in cosmetically sensitive locations or complex reconstructions |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
C44.01 | Basal cell carcinoma of skin of lip | Common malignant diagnosis prompting excision or biopsy for diagnosis and treatment planning |
C44.51 | Squamous cell carcinoma of skin of trunk | Squamous cell carcinomas frequently require biopsy or excision for diagnosis and margin assessment |
D22.9 | Melanocytic nevus, unspecified | Benign pigmented lesions that may be excised for diagnostic confirmation or cosmetic/ symptomatic reasons |
D23.9 | Other benign neoplasm of skin, unspecified | General code for benign skin lesions removed for diagnosis, symptoms, or patient preference |
L98.9 | Disorder of skin and subcutaneous tissue, unspecified | Used when a more specific dermatologic diagnosis is not established at time of procedure |
L08.9 | Local infection of skin and subcutaneous tissue, unspecified | Skin infections or non-healing ulcers may necessitate debridement or diagnostic sampling |
Z48.02 | Encounter for removal of sutures | Relevant for follow-up care after excision and repair procedures |
Z85.820 | Personal history of malignant melanoma of skin | Relevant to surveillance and lower threshold for biopsy or excision of suspicious lesions |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
11102 | Tangential biopsy of skin (e.g., shave), single lesion | Performed as an alternative diagnostic technique when a shave biopsy suffices instead of full excision |
11104 | Tangential biopsy of skin, multiple lesions, up to 14 | Used when multiple shave biopsies are performed during the same encounter |
11600 | Excision, benign lesion including margins, trunk, arms or legs; diameter 0.5 cm or less | Commonly used for benign lesion excisions; size-based codes may be selected instead of 1160F depending on documentation |
12001 | Repair, simple, superficial wounds of scalp, neck, axillae, external genitalia, trunk or extremities; 2.5 cm or less | Used for layered closure or repair following excision when wound closure is required |
88305 | Level IV surgical pathology, gross and microscopic examination | Pathology CPT typically reported by the laboratory to interpret the excised specimen and provide diagnosis |
99213 | Office or other outpatient visit for the evaluation and management of an established patient, moderate severity | Represents an E/M visit that may occur pre- or post-procedure when separately reportable (see modifier 25) |