Dermatology Coding Alert

Question: How should I code for laser destruction of penile lesions with CO2 laser when there are 50 or more lesions to treat?

North Dakota Subscriber

Answer: Codes 54057 (Destruction of lesion[s], penis [e.g., condyloma, papilloma, molluscum contagiosum, herpetic vesicle], simple; laser surgery) and 54065 (Destruction of lesion[s], penis [e.g., condyloma, papilloma, molluscum contagiosum, herpetic vesicle],extensive [e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery]) correctly identify the procedure you are trying to code. Your choice of code depends on whether the destruction of the lesions would be classified as simple or complex.

For a simple lesion destruction, strict interpretation of 54057 indicates that you should report the code once only, regardless of the number of lesions the dermatologist removed. If the dermatologist removed a large number of lesions, however, you may classify the procedure as extensive. Your best option is to call your carrier and ask it whether the number of lesions can designate a procedure as "extensive," in which case 54065 would be the appropriate code.

For the above case, you would use 54065 as the proper code. Also sequence codes 17110 (Destruction [e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement], of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions) to 17111 (... 15 or more lesions) for similar lesions found in the genital area outside of the area of the penis.