Oncology & Hematology Coding Alert

Texas Subscriber

Answer: Excision and destruction are two different approaches to treatment of basal cell carcinoma. Excision means that your physician removed tissue to eliminate the cancer. Destruction implies your physician adopted a different method, such as liquid nitrogen, to obliterate the cancer cells. Because basal cell carcinoma is a malignancy, you need to choose the excision or destruction codes accordingly.

Excision: For lesion excision, you’ll 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 anatomical site and excised diameter (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 lesions determined to be premalignant.

For medical necessity: Don’t forget to add the appropriate anatomically specific code from C44.- (Other and unspecified malignant neoplasm of skin) using the most specific location to describe the neoplasm.