Tangential biopsy (11102) + Punch biopsy (11104)
Multiple biopsy codes can be reported per site with anatomical specificity — bundling depends on whether multiple distinct lesions sampled.
Why this pair bundles
Each distinct lesion biopsied separately is separately reportable. Same lesion two techniques = bundled.
Modifier-bypass policy
Modifier indicator: 1 — modifier 59 / XE / XP / XS / XU permitted when supporting documentation is on file.
Modifier 59 or XP (separate practitioner) when distinct lesions sampled with different techniques.
Documentation requirements
- Each lesion described with anatomical location
- Biopsy technique per lesion
Common clinical scenarios
- Dermatology visit sampling 3 different suspicious lesions with different techniques
Frequently asked questions
Why does CMS bundle 11102 and 11104?
Each distinct lesion biopsied separately is separately reportable. Same lesion two techniques = bundled.
When can I use modifier 59 (or X{EPSU}) to bypass?
Modifier 59 or XP (separate practitioner) when distinct lesions sampled with different techniques.
What documentation supports separate billing?
Each lesion described with anatomical location; Biopsy technique per lesion.
When does this conflict typically arise?
Dermatology visit sampling 3 different suspicious lesions with different techniques.
Sources
Catch NCCI 11102/11104 conflicts before submission
ApprovalHelp auto-flags NCCI bundling conflicts on the claim line before you submit. Modifier-bypass eligibility checked against current quarterly NCCI tables. no setup fee.
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