From Lesion Removal to Biopsies

Are you confident that your dermatology practice is using the most accurate CPT codes for 2026? Correct coding is not just a billing requirement; it’s essential for ensuring compliance, maximizing reimbursement, and maintaining clear patient records. With the latest updates, dermatology procedures, from routine skin biopsies and lesion removals to advanced Mohs surgery and phototherapy, each has specific CPT codes that must be applied correctly. 

This article breaks down the essential dermatology CPT codes for 2026, offering clear explanations, practical examples, and expert tips to help dermatologists, coders, and billing specialists navigate the complexities of dermatology coding with confidence and precision.

1. Skin Biopsy CPT Codes

Skin biopsies are a cornerstone of dermatologic diagnosis. Selecting the correct CPT code depends on the type of biopsy, the number of lesions, and the anatomical site. Accurate coding not only ensures proper reimbursement but also maintains compliance with insurance and regulatory standards.

Tangential Biopsies

• 11102: Tangential biopsy of a single lesion.
• 11103: Tangential biopsy of each additional lesion after the first.

Example: If a patient presents with two suspicious lesions and a tangential biopsy is performed on both, bill 11102 for the first lesion and 11103 for the second.

Punch Biopsies

• 11104: Punch biopsy of a single lesion.
• 11105: Each additional punch biopsy after the first.

Punch biopsies are commonly used for inflammatory skin disorders or small suspicious lesions. Document the number of punches and the exact site for accurate coding.

Incisional Biopsies

• 11106: Incisional biopsy of a single lesion.
• 11107: Additional incisional biopsy after the first.

Incisional biopsies involve removing a portion of a lesion, often for large or complex tumors. Precise documentation of size and location is critical.

Special Site Biopsies

• 40490: Biopsy of the lip.
• 69100: Biopsy of the external ear.

Always note the anatomical site in the patient record. Special site biopsies often require distinct CPT codes due to complexity or higher risk.

2. Lesion Removal CPT Codes

Lesion removal includes techniques such as cryotherapy, laser ablation, chemical destruction, or electrocautery. CPT codes differ based on lesion type, number, and whether it’s premalignant or benign.

• 17000: Removal of a single premalignant lesion.
• 17110: Removal of up to 14 benign lesions (excluding skin tags or vascular proliferative lesions).

Key Considerations:

• Count each lesion accurately; multiple lesions have separate codes.
• Document the method of destruction (cryotherapy, chemical, laser) for proper coding.

If a patient has 10 benign lesions treated with cryotherapy, bill 17110 once for all lesions, noting the method in the procedure note.

3. Lesion Excision CPT Codes

Excision involves surgical removal of lesions, either benign or malignant. Correct coding depends on lesion size, malignancy status, and anatomical location.

Benign Lesion Excision

• 11403: Excision of a benign lesion 2.1–3.0 cm on the trunk, arms, or legs.

Malignant Lesion Excision

• 11603: Excision of a malignant lesion 2.1–3.0 cm on the trunk, arms, or legs.

Tips for Accurate Coding:

• Document lesion size in centimeters (important for differentiating codes).
• Record lesion type (benign vs. malignant) clearly in clinical notes.
• Include location details; coding varies by site due to complexity.

For multiple lesions excised during the same session, each additional lesion requires a separate CPT code, depending on size and type.

4. Mohs Micrographic Surgery CPT Codes

Mohs surgery is a highly precise surgical technique for skin cancer removal, combining surgery and pathology by the same physician. CPT coding depends on stage, lesion site, and complexity.

• 17311: First stage for a single lesion on high-complexity sites (head, neck, hands, feet, genitalia, or areas involving muscle, cartilage, bone, tendon, major nerves, or vessels).
• 17313: First stage for a single lesion on the trunk, arms, or legs.

Important Notes:

• Document each stage of Mohs surgery separately.
• Additional stages and lesions have distinct CPT codes.
• Mohs surgery often leads to higher reimbursement due to complexity and precision.

Always include site, lesion size, and stage count in the operative report for accurate billing.

5. Dermatology Pathology CPT Codes

Pathology plays a critical role in dermatology by providing microscopic examination of biopsied or excised tissue. Accurate coding ensures that labs are reimbursed correctly and supports clinical decision-making.

Common Pathology Codes:

• 88304: Level III examination of a specimen.
• 88305: Level IV examination of a specimen.
• 88312: Special stain including interpretation and support.
• 88341: Additional immunohistochemistry (IHC) or immunocytochemistry (ICC) stain. Typically used with 88342, which represents the initial single antibody stain.

Tips for Accurate Billing:

• Always note the number of levels examined and the stains performed.
• Special stains or IHC procedures require additional CPT codes, reflecting their complexity.
• Proper documentation ensures that the pathology work is accurately reimbursed.

6. Phototherapy CPT Codes

Phototherapy is used to treat skin conditions like psoriasis, eczema, or premalignant lesions through ultraviolet light or photosensitive drugs.

• 96900: Actinotherapy without the use of tars, petrolatum, or psoralens.
• 96910: Photochemotherapy using tar and UVB, or petrolatum and UVB.
• 96567: Photodynamic therapy (PDT) to destroy premalignant or malignant lesions using photosensitive drugs.

Pro Tips:

• Document treatment type, duration, and area treated for accurate CPT coding.
• Phototherapy CPT codes vary depending on whether topical photosensitizers are used.

7. Radiation Oncology CPT Codes in Dermatology

Radiation therapy is sometimes used in dermatology for skin cancers or aggressive lesions. The CPT codes depend on planning, delivery, and management of treatment.

• 77261: Clinical treatment planning.
• 77336: Ongoing medical physics consultation during therapy.
• G6012: Radiation treatment delivery for three or more separate areas, with custom setups.
• 77427: Radiation treatment management for a set of 5 treatments.

Tips for Accurate Billing:

• Document each treatment session carefully, including area treated, energy used, and custom setup.
• Coordination with the medical physicist and oncologist is essential for compliance.

8. Vein Treatment CPT Codes

Dermatologists also treat varicose veins and other vascular abnormalities using minimally invasive procedures. CPT coding depends on treatment type, guidance used, and number of veins treated.

• 36475: Endovenous radiofrequency ablation (extremity).
• 36478: Endovenous ablation therapy, including imaging guidance.
• 36465: Sclerotherapy of a single vein.
• 36482: Endovenous ablation of a single vein with chemical adhesive.
• 37765: Initial stab phlebectomy of a varicose vein.
• 76942: Ultrasound guidance for needle placement in non-vascular procedures.

Tips for Accurate Coding:

• Record the number of veins treated, technique, and use of imaging guidance.
• Each procedure has distinct CPT codes depending on whether it’s chemical, thermal, or surgical.

Summary

Accurate dermatology CPT coding in 2026 is essential for compliance, proper reimbursement, and high-quality patient care. From skin biopsies and lesion removals to Mohs surgery, phototherapy, and vein treatments, each procedure has a specific CPT code that must be applied correctly.

• Always document lesion type, size, number, and location.
• Use the correct CPT code for the procedure type and anatomical site.
• Stay updated with 2026 CPT revisions to reduce claim denials and improve practice efficiency.

By mastering these codes, dermatologists, coders, and billing specialists can confidently navigate the 2026 landscape, ensuring accurate billing, compliance, and optimal patient care.