Dermatology Coding Alert

You Be the Coder:

Basal Cell Carcinoma Destruction

Published on Tue Dec 23, 2014

Question: Sometimes our surgeon excises in situ basal cell carcinoma, but sometimes he uses “destruction” methods such as liquid nitrogen for small lesions. How should I code these?

Texas Subscriber

Answer: Because basal cell carcinoma is a malignancy, you need to choose the excision or destruction codes accordingly.

Excision: For lesion excision, choose a code such as 11603 (Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 2.1 to 3.0 cm). CPT® provides 18 codes in the range 11600-11646 to choose from, depending on the malignant lesion site and size. You should not use a code from the range 11400-11446 (Excision, benign lesion including margins, except skin tag …), which describe benign lesion excisions.

Destruction: For destruction, choose a code from the range 17260-17286 (Destruction malignant lesion …). Avoid codes in the range 17000-17004 (Destruction … premalignant lesions…), because those are for benign lesions.

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