Summary & Overview
CPT 11922: Medical Tattooing for Permanent Camouflage of Skin Defects
CPT code 11922 designates additional surface area for medical tattooing used to provide permanent camouflage of skin color defects caused by congenital anomalies, breast reconstruction, burns, vitiligo, birthmarks, and similar conditions. The code applies to each additional 20.0 cm2, or part thereof, beyond the initial treated 20.0 cm2, making it a unit-based add-on for procedures where pigment implantation covers larger areas. Nationally, this code matters for clinicians in dermatology and plastic surgery and for payers managing coverage and payment for reconstructive and restorative services.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for use of CPT code 11922, typical sites of service, and the unit-based nature of the code. The publication also summarizes benchmarks and payer policy patterns where available, highlights relevant coding practice considerations for surface-area billing, and outlines how this code fits within reconstructive and dermatologic service lines. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 11922 describes a dermatologic tattooing procedure that implants intradermal insoluble opaque pigments to correct skin color defects. The procedure is intended as a permanent camouflage for defects arising from congenital anomalies, breast reconstruction, burns, vitiligo, birthmarks, and similar conditions. CPT code 11922 represents each additional 20.0 cm2, or part thereof, after the first 20.0 cm2.
Service type: Medical tattooing / permanent camouflage for skin defects
Typical site of service: Outpatient dermatology clinic, plastic surgery clinic, or ambulatory surgery center
Clinical & Coding Specifications
Clinical Context
A 38-year-old female presents to a dermatologic surgical clinic several months after unilateral mastectomy and implant-based breast reconstruction. She requests areola complex pigmentation to restore symmetry and camouflage the surgical site. The provider evaluates the reconstructed breast, discusses expectations and risks of intradermal pigment implantation (medical tattooing/microvascular pigment placement), confirms no active infection or uncontrolled bleeding disorder, obtains informed consent, and schedules the procedure. On the day of service the patient is positioned in a minor procedure room or ambulatory surgery center; local anesthesia is administered as needed. The provider applies intradermal insoluble opaque pigments to the reconstructed areola and nipple area. If the treated surface exceeds the initial 20.0 cm2, billing uses 11921 for the first 20.0 cm2 and 11922 for each additional 20.0 cm2 or part thereof. The typical site of service is an outpatient dermatology or plastic surgery clinic, ambulatory surgical center, or physician office procedure room. Post-procedure instructions address wound care, pigment maturation, and a follow-up visit for touch-ups if needed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normal bilateral or usual preoperative service |