# CO2 Ablation with excision



## bethh05

The physician performs CO2 laser ablation of penile condyloma then he performs excision with layered closure of two of the largest condyloma and sends off for pathology. 54057 and 54060 bundle but then the notes state that 54050-54065 excludes 11420-11426. I am unclear on what codes should/can be used for the excision of the larger condyloma? Any help is greatly appreciated!!


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## magnolia1

bethh05 said:


> The physician performs CO2 laser ablation of penile condyloma then he performs excision with layered closure of two of the largest condyloma and sends off for pathology. 54057 and 54060 bundle but then the notes state that 54050-54065 excludes 11420-11426. I am unclear on what codes should/can be used for the excision of the larger condyloma? Any help is greatly appreciated!!




Have you considered using modifier "59" on your codes from the 11420-11426 range?
If ablation was done on lesions other than the ones excised, you can code these procedures separately.


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## Kevinph84

I would recommend using the CPT 54065. I also ran the NCCI edits on my ASCExpert encoder and both CPT 54060 and 54057 are bundled in CPT 54065. I included the code description and a lay description from my encoder below. 


54065  
Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)  


The physician destroys extensive lesions of the penis using one or more of several methods. Extensive destruction generally means the procedure took more time or was more difficult than usual due to such factors as the size and number of lesions involved. The methods used by the physician include local application of a chemical, freezing, electrodesiccation, laser vaporization to kill the diseased tissue, or *excision*. Local anesthesia may be used for these procedures. The physician applies the method only to the specific lesions.


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