Dermatology Coding: Stay Away From Adding Lesion Sizes Together

By Author: erinarticle
Total Articles: 106
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In a particular scenario, a doctor removed three lesions from the scalp area with surgitron (a device used for radiosurgery) and coated with bacitracin ointment. As such do you put them all together into one code even though they're at different sites (3mm, 1mm, and 4mm)?


Well, you should code this service as a 'destruction' procedure. You should take a look at your documentation to check if the lesions were benign or malignant so that you can properly code the service.


For example, if the three lesions you described were benign, report 17110 (Destruction [example, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement], of benign lesions apart from skin tags or cutaneous vascular lesions; up to 14 lesions). This code describes up to 14 lesions.


Thumb rule: You should never add the lesion sizes together for a destruction or removal. Since the size given in millimeters, you may have to convert it to centimeters as most medical coders do. You can code each lesion independently, unless of course you're reporting 17110. If the three lesions ...
... are malignant, you would report 17270 (Destruction, malignant lesion [example, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement], scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less), 17270-59 (Distinct procedural service), and 17270-59.


Point to remember: You should use modifier 59 when you are billing more than one procedure on the same body area carried out at the same session.


For more on this, and for other specialty-specific articles to assist your dermatology coding, sign up for a good medical coding resource like Coding Institute.