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Thread: Intralesional injection vs Destruction

  1. #1

    Smile Intralesional injection vs Destruction

    AAPC: Back to School
    I know the use of candida antigen has been discussed in this forum before, but I need opinions please on this situation. Doc is injecting candida antigen for treatment of viral warts. Obvious coding for me is 11900/11901 + J3490 for the candida antigen if nothing else is done to the lesion on that day. However, doc believes that 17110 is more appropriate because description says "any method" and "chemical treatment". I believe that 17110 would be appropriate perhaps if the lesion was treated with a chemical topically or by one of the other means mentioned in CPT, but the intralesional injection is the more specific code in this case. And what about use of 96405/96406 for chemo admin? Would injection of candida antigen be considered "chemotherapy administration"?

    Opinions Please, to justify either coding method.

    Thanks a bunch!

  2. #2


    I'd also be inclined to go with 11900/11901 vs. 17110. While CPT does say "any method" if you look at the standard edition, it states "Any method includes electrosurgery, cryosurgery, laser and chemical treatment." Also I think the way you coded it is a better description of what was actually done.

    Hope this helps.

    Jess H., CPCD

  3. #3


    Thank you, Jess!

  4. #4


    Yes you are right and justified in assigning the code 11900,11901.

    Candida antigen therapy as injection:
    causes the immune system to become very active in that area.
    Since it is not an immunosuppressant agent but an immunostimulatory agent, the better code choice would be the J3490. That is why we do not assign the code J7599

    Code 11900/11901, Injection, intralesional lesions up to 7 or over 7 lesions (not the amount of needle sticks per lesion).

    But it is not chemotherapy. It is an immunotherapy. it produces a host immune response to the wart virus, resulting in wart resolution.
    It said to bring about resolution of distant sited wart.
    It is believed that some chemotheraputic agents like 5 flurouracil can bring about some resolution effect on wart.
    Last edited by preserene; 08-21-2010 at 11:05 AM.

  5. #5

    Default Biller/Coder

    I am trying to code BCG for melanoma under medicare. I used 90585 but medicare does not covered it, is there another code I can use

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