September 19, 2019

Question:
Do you have to await the pathology report in order to assign the diagnosis of benign or malignant for a lesion; when reporting destruction codes 17000-17111 or any lesion removal codes?

Answer:
There are multiple answers to your question depending on which piece is addressed. I will try to address them separately. If a destruction is performed, there should not be anything sent to pathology. You would report the destruction code by the diagnosis that the physician documents for the destruction; 17000-17004 are for actinic keratosis(es), which are premalignant. 17110 and 17111 are for seborrheic keratosis(es) and other benign lesions.

For excision of lesions, this is different. If the type of lesion is unknown, the coding must be held until the pathology comes back as the codes for lesion excision are broken down by site, size, and type (benign or malignant).

For skin biopsies, the coding may be reported right away. There are now 6 skin biopsy codes broken down by method (tangential, punch, and incisional) and number of lesions biopsied.

*This response is based on the best information available as of 09/19/19.