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KaylaRieken

True Blue
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527
Location
Waukee, IA
If provider says he resected a 3 X 5 cm tumor, would I use 52235 or 52240? Going back and forth on this one.
 
I would go with 52235 because this code is "up to 5 cm", so your largest measurement here is 5 cm. This code does not say "square cm", so you wouldn't multiply it to come up with 15 cm to get your size, make sense?
 
KaylaRieken said:
If provider says he resected a 3 X 5 cm tumor, would I use 52235 or 52240? Going back and forth on this one.
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I would go with 52235 because this code is "up to 5 cm", so your largest measurement here is 5 cm. This code does not say "square cm", so you wouldn't multiply it to come up with 15 cm to get your size, make sense?
 
I agree with 52235. Per CPT Assistant, May 2016: "Report code 52235 when one or more of the tumors is between 2.0 cm and 5.0 cm. Report code 52240 when one or more of the tumors is larger than 5.0 cm." It's a fine line of course, but if the largest documented dimension of the tumor is 5.0 cm, then the tumor is not 'larger than 5.0 cm' and 52240 is not supported.
 
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