CPT 1200F: Quality Measure Reporting

CPT code 1200F is a Category II performance measure code used to report clinical quality information. Category II codes are intended to facilitate data collection about quality of care and performance measurement; they do not represent billable procedures in the same way as Category I CPT codes but are used alongside claims to document that a specified measure was met. Nationally, such performance measure codes matter for quality reporting programs, payer reporting requirements, and value-based payment models that incorporate structured clinical data.

Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of what the code represents, the service context for its use, and the typical sites where reporting occurs. The publication outlines how the code fits into quality measurement workflows, common reporting pathways, and areas where policy updates or payer-specific guidance may affect documentation and claims processing. The summary clarifies available information and notes where input data is incomplete: several metadata fields are not provided in the source input, and those items are explicitly identified as unavailable.

Billing Code Overview

CPT code 1200F denotes a performance measure category entry with no summary available in the input. Based on the code structure, it is a CPT Category II performance measure used to report clinical quality information. Service type: Quality measurement/reporting. Typical site of service: Performance measure reporting occurs across outpatient and inpatient clinical settings where quality metrics are captured.

Data not available in the input.

Clinical Context

A typical patient is an adult presenting to an outpatient dermatology or primary care clinic with a small, uncomplicated skin lesion—such as a superficial laceration, small benign lesion excision, or simple wound—requiring a short, focused procedure for repair or removal. The patient has a localized problem (e.g., small cut, biopsy site, or skin tag) without involvement of deep structures. The clinical workflow includes intake and focused history, local anesthesia administration, limited procedural time (typically brief, minor procedure room), performance of the simple procedure (e.g., simple repair, shave biopsy, or removal), hemostasis, wound dressing, and brief post-procedure instructions. Typical sites of service are outpatient clinic procedure rooms, urgent care centers, or office-based minor procedure suites. The encounter is frequently billed by the attending clinician with supporting documentation of indication, procedure performed, anesthesia, and materials used.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure	Use when a distinct E/M visit is performed in addition to the procedure and documentation supports separate work.
`59`

Taxonomy Code	Specialty	Notes
207Q00000X	Dermatology	Common specialty performing minor skin procedures, excisions, and biopsies.
207P00000X	Family Medicine	Often performs office-based repairs, skin lesion removals, and minor procedures.
208000000X	Internal Medicine	Performs minor office procedures and diagnostics in outpatient settings.
363A00000X	Emergency Medicine	Performs urgent minor procedures and laceration repairs in ED/urgent care.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S01.01XA`	Open wound of scalp, initial encounter	Represents acute superficial lacerations of the scalp requiring simple repair or cleaning.
`S31.01XA`	Open wound of anterior abdominal wall, initial encounter	Example of superficial wounds on trunk suitable for simple office procedures.
`L91.8`	Other hypertrophic disorders of skin	May be relevant for minor procedures addressing scar revision or localized skin abnormality.
`D23.9`	Benign neoplasm of skin, unspecified	Common indication for lesion removal or biopsy performed as a minor procedure.
`R21`	Rash and other nonspecific skin eruption	May prompt a diagnostic biopsy or limited procedure for symptomatic relief or sampling.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`12001`	Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk or extremities; 2.5 cm or less	Commonly performed for small lacerations or superficial wound repairs that are similar in scope to minor office procedures.
`11102`	Tangential biopsy of skin, single lesion	Performed when a superficial lesion requires diagnostic sampling instead of excision; may precede definitive treatment.
`11400`	Excision, benign lesion, skin; trunk, arms or legs; excised diameter 0.5 cm or less	Used when a benign skin lesion requires complete excision rather than a simple procedure; may be an alternative or follow-up.
`99024`	Postoperative follow-up visit, global services not changed	Used for routine postoperative visits within the global period for minor procedures.
`99070`	Supplies and materials (e.g., sutures, bandages) provided by physician over and above those usually included with the office visit	Used to bill for disposable supplies used during minor procedures when payor permits.

OpenPayer

Summary & Overview