Coding Destruction of Lesions

“Spotlight on CPT” is covering destruction of benign, premalignant, and malignant lesions in this installment. Destruction of lesion procedures requires that coding professionals recognize that there is a difference in codes assigned based on whether the lesion is benign, premalignant, or malignant. A key fact to remember is that there will not be a pathology report when tissue is destroyed. Therefore, use the provider’s documentation to identify which type of lesion has been destroyed.

Benign lesion destruction of lesions is coded to either 17110 when removal of up to 14 lesions is performed (1-14) or 17111 when 15 or more lesions have been destroyed. Only one of these codes should be assigned per encounter. Therefore, if a patient had 25 benign lesions destroyed, then only code 17111 will be coded.

Destruction of premalignant lesions is also based on the number of lesions removed. The first premalignant lesion destroyed is coded as 17000. If up to 14 premalignant lesions are removed, add-on code 17003 is assigned for each lesion destroyed. If 15 or more premalignant lesions are destroyed, then the code assignment is 17004. This means if six premalignant lesions are destroyed, the codes would be 17000 and 17003 x 5. If sixteen lesions were destroyed, then the code assignment is only 17004.

The destruction of malignant lesions is very different than what we have seen so far. The destruction of malignant lesions is based on anatomic location and size of the lesion as outlined below:

•       Anatomical Location

•       Trunk, arms, or legs

•       Scalp, neck, hands, feet, genitalia

•       Face, ears, eyelids, nose, lips, mucous membrane

•       Size

•       0.5 cm or less

•       0.6 to 1.0 cm

•       1.1 to 2.0 cm

•       2.1 to 3.0 cm

•       3.1 to 4.0 cm

•       Over 4.0 cm

This means that every malignant lesion that is destroyed will have an individual code whether that is two or twenty. Again, coding professionals will rely on the provider’s documentation of malignancy as no pathology will be performed.

Destruction may be achieved by laser, cryosurgery, chemosurgery, curettement, or electrosurgery. Local anesthesia and simple closure, if necessary, are included in these codes.

Now, light has been shed on coding destruction of lesions.

 

 

About the Author

Dianna Foley, RHIA, CHPS, CCS, CDIP, has 25 years of HIM experience. She earned her bachelor’s degree from the University of Cincinnati and holds RHIA, CHPS, CDIP, and CCS certifications from AHIMA. Dianna’s an AHIMA-approved ICD-10-CM/PCS trainer, an AHIMA-published author, a participant in AHIMA credential item writing and exam development, and served on the AHIMA Nominating Committee. Dianna has held various HIM positions and is now an independent coding consultant. She previously served as Eastern Gateway Community College’s program director for Medical Coding and HIT. She presents on coding topics at the national, state, and regional levels and serves as OHIMA’s Education Coordinator.