Oncology & Hematology Coding Alert

Question: How do you code epidermoid carcinoma of the lip, with wide excision of the lesion of the lip? Should I use 173.0, 27.42?

Seattle Subscriber

Answer: Epidermoid is a tumor of the skin. When coding the diagnosis of an epidermoid carcinoma of the lip, look in the neoplasm, neoplastic table of the ICD-9 code book under the main term lip; look for the subterm skin, which references code 173.0 (skin of lip). After confirming this code in the tabular section, you will see that code 173.0 is the correct code for an epidermoid carcinoma of the lip. According to the ICD-9, code 173.0 applies to all neoplasms of the skin of the lip, excluding the vermilion border of the lip.

Code 27.42 would be correct if you were coding the procedure for a hospital. Use the CPT manual to code for the professional services of the physician. To choose a correct CPT code I would need to know the size of the lesion. Without that information, I can tell you that the appropriate code is found in the code range of 11640-11646 (excision, malignant lesion, face, ears, eyelids, nose, lips).

Editors note: Laurie Castillo, MA, CPC, president of Physician Coding & Compliance Consulting, and the American Association of Procedural Coders Northern Virginia Chapter in Manassas, Va., provided advice for answering this question.