Forum - Questions & Answers

Jul 16th, 2016 - jswhit 2 

daily limit for skin biopsies CPT® 11100 & 11101?

Our office has had 2 recent claims for 11100 qty of 1 & 11101 qty of 7 denied by Medicare. We also had another claim for 11100 qty of 1 & 11101 qty of 11 denied as well. Is there a limit on the number of biopsies that can be done on one day according to Medicare? We haven't been able to find a definitive answer as to whether there is a daily limit or not. Any help would be appreciated. Thanks.

Jul 16th, 2016 - petunia 195 

re: daily limit for skin biopsies CPT® 11100 & 11101?

11101 has a MUE of 6. We typically bill what we do and then appeal with good documentation and Med necessity they will consider more.



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