Billing code
Z113A — Biopsy(ies) - any method, when sutures are not used
Skin biopsy without sutures
Bill for one or more skin or subcutaneous biopsies, by any method, when no sutures are used.
Watch for: If the site is closed with sutures, bill Z116 instead.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $32.45 | $0.00 | $0.00 | $0.00 | $0.00 |
- Code
- Z113A
- Description
- Biopsy(ies) - any method, when sutures are not used
- FHO+ basket
- Covered by the FHO+ base rate payment for enrolled patients, and shadow billed at 30% (50% for Schedule 2B procedures).
- Effective date
- Apr 1, 2026
- Termination date
- No end date
Explanation
Updated October 26, 2026
Skin or subcutaneous biopsy, one or more, by any method when no sutures are used. With sutures, bill Z116.
What it covers
Z113 is biopsy (one or more) by any method when sutures are not used (M1). The same biopsy closed with sutures is Z116 (M1).
An extensive or complicated biopsy, or one needing a general anaesthetic as the sole procedure, is Z155 on an independent consideration basis (M2, GP12). As a Z code, Z113 is an independent operative procedure, payable in addition to an assessment (GP4).
Billing rules
- Use Z113 only when no sutures are placed; if the site is sutured, bill Z116 (M1).
- If you did the major pre-operative visit in the previous 12 months, only a minor assessment (GP/FP) or partial assessment (specialist) is payable before the biopsy that day; if the decision is made at that day's visit, no other assessment before the IOP (SP4).
- An unrelated, significant problem in another body system assessed at the same visit can be billed as well (SP4).
- FHO: in basket (Schedule 2), and a Schedule 2B code, so shadow billing for enrolled patients is 50% of the fee; it also counts toward the Schedule 4 office procedures payment (Agreement p.59 §4.4, p.80, p.87, p.67 §8.7, p.94).
Often billed with
- A007 intermediate assessment at the visit where the decision to biopsy is made (GP4, SP4).
Related codes: Z116, Z117, Z118, R048, R094
Source: Schedule of Benefits (July 1, 2026), Integumentary System Surgical Procedures, Skin and Subcutaneous Tissue, Biopsy(ies), pages M1 to M2; Surgical Preamble SP4; FHO Agreement 2026-04 pp.59, 80, 87, 94
APEX checks every paid claim against the Schedule of Benefits and flags codes billed below what the visit qualified for. See how APEX works · Pricing