CPT® Code 11104

A punch biopsy is a medical procedure used to obtain a cylindrical sample of skin tissue for diagnostic purposes. This technique is particularly useful for evaluating various skin lesions, which may include pigmented nevi (moles), superficial inflammatory dermatoses (skin conditions characterized by inflammation), papulosquamous disorders (conditions that cause raised, scaly patches), granulomatous diseases (inflammatory conditions that result in the formation of granulomas), bullous disorders (conditions that cause blisters), connective tissue disorders, and benign tumors that appear non-cancerous. During the procedure, the skin is first anesthetized to minimize discomfort. A punch tool, which is a circular instrument of varying sizes, is selected based on the lesion's dimensions. The skin is then stretched perpendicular to the natural tension lines to facilitate a clean cut. The punch tool is applied to the skin and rotated to penetrate through the epidermis and into the reticular dermis and subcutaneous fat, capturing a full-thickness sample of the skin. Once the punch tool is removed, the edge of the specimen is grasped with forceps, lifted, and excised at the base using scissors. To manage any bleeding that may occur, techniques such as electrocautery, aluminum chloride application, or Monsel’s solution may be employed. After the biopsy, the resulting defect can be closed using simple sutures, staples, gelfoam, or adhesive bandages, which may involve basic manipulation to align the edges of the wound for optimal healing. The procedure is coded as CPT® Code 11104 when a single lesion is removed, including any simple closure performed, while CPT® Code 11105 is used to report each additional lesion biopsied.