Oncology & Hematology Coding Alert

Question: Is there a difference between excision and destruction of basal cell carcinoma? How can we appropriately report these two procedures?

Texas Subscriber

Answer: Excision and destruction of basal cell carcinoma are two different approaches to treatment. Excision means that your physician removed a piece of tissue to eliminate the cancer tissue. Destruction implies your physician adopted a different method, example, 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, 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 lesions determined to be pre-malignant.