Wiki Methotrexate IL for SCC destruction

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jhynek

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Hello! Has anyone had a Provider use IL Methotrexate for destruction of a squamous cell carcinoma? How would you recommend this be billed? CPT 17261 was billed, but I do not feel that is correct as there was no curettage performed, no indication of lesion size plus margins, and no documentation of strength and dose. Also it is not a biopsy proven SCC, only clinically diagnosed. Please let me know your thoughts!!
 
Look at 96405


96405 Chemotherapy administration, intralesional; up to and including 7 lesions

Methotrexate is an anti-neoplastic drug. 96405 is used for injecting anti-neoplastics into malignant lesions
 
96405 vs 11900

Thank you for the response! Confusing part in the AMA/CPT guidelines it makes it seem like typically these codes are used for highly complex agents where you are monitoring the patient for significant side effects before, during, and after treatment and advance training is required for preparation of med, dosage, and disposal...which is not the case with the low dose/strength MTX, as there is minimal risk involved for patient side effects vs significant risk as noted by the AMA. I was thinking it would be more on the lines of the 11900 as it lacks the complexity that other chemo treatments would have where you are getting vitals on the patient etc. What constitutes it being the 96405 code other than it being an anti-neoplastic drug for IL injection?
 
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