Wiki Dysplastic nevus CPT code for destruction?

[graciejean]

A patient has a biopsy of the lesion of the right shoulder. The pathology report states compund dysplastic nevus margin is positive. The patient comes back. The procedure: The lesion was destroyed by 6 mm excision. Healing by secondary intention. Pathology was sent. A punch biopsy of the skin right shoulder was sent to pathology which stated no residual nevus seen. Margins negative.
Is dysplastic nevus considered premalignant by CPT? Would you report 17000 or 17110?

 

[jahcpc]

If the Doctor did an excision of the lesion, then you would code a benign excision 11401 with dx 238.2.

 

[graciejean]

Destruction procedure dysplastic nevus

In this case the physician wanted to bill the destruction of a premalignant lesion. 17000. Would dysplastic nevus be considered premalignant, benign or neoplasm of uncertain behavior (238.2)? If it was destroyed, would code 17000 or 17110 be reported?

 

[Pam Warren]

Destruction and excision are not the same thing.
Destruction codes are not typically used if there needs to be a specimen sent to pathology; the code describes the procedure: essentially the tissue is destryoed by cryocautery. laser or chemical destruction. There's nothing left to send.

If you sent a punch Bx, use 11000. If a scalpel was used to do an excision, use the codes in the 1140x series.

I would not consider a dysplastic lesion to be pre-malignant, and I would wait for the second pathology report before coding the excision.