Wiki Shave Biopsy vs Destruction code

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susie09

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Hello, Need help on coding this,
patient comes in for a shave biopsy per the notes the lesion is also treated with curettage and electrodissecation times 3 on the Forearm, the path report comes back as Squamous Cell, the doctor is coded it as 17261 with a dx of 173.62, measurements are 0.5x0.4x0.1 from the path report which is not listed in the medical notes, I believe this is incorrect and think it should be 11301 with a DX of 239.2.

Any help would be greatly appreciated
 
I found this on AAD, seems like your situation is similar to the example given:

https://www.aad.org/members/publica...truction-codes-face-overutilization-challenge

Example 5: A 0.6 cm flat, red to black lesion on the arm of a 32-year-old tanning bed user is diagnosed as a probable pigmented basal cell carcinoma, with melanoma a less likely consideration. The lesion is shaved off with a blade, including a 0.2 cm margin. The wound base is then electrodessicated and curetted, leaving a 1.0 cm wound. Pathology confirms a pigmented basal cell carcinoma, and the deep and lateral margins are uninvolved.

This procedure is appropriately reported as 17261: destruction malignant lesion arm, 0.6-1.0 cm diameter. It is not reported as an excision, because the level of removal did not extend through the dermis, nor would it be reported as a shave removal because the lesion was destroyed after the specimen was obtained for pathology.
 
I think it really comes down to intent.

Since it sounds like the provider knew it was most likely malignant, he took a piece of it and destroyed the rest of it so the intent seems to be to destroy the lesion and have confirmation by sending most of it to the lab.
 
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