For the codes 17260-17286, the CPT states "Destruction malignan lesion...lesion diameter..."

So in auditing a file the clinician states, "size of lesion after curettment 0.9cm". I tell him that the measurement is the 'lesion diameter' but the guidelines do not indicate anything about 'after curettment'. He then shows me a manual published by a well know "Dermatology Coding Practice Management Group" that states, "In order to code for destruction of malignant lesions (CPT codes 17260 to 17286), the size of the lesion after curettage is measured. Do not use the resultant electrodessicated area as your measurement for code selection."

I can find no other source for this information. The Amercian Academy of Dermatology Coding Manual is silent on this topic, I have googled, I have sent queries to other Derm coders and can find no one else that knows anything about this.

How about this group? Any help on finding out where this information is coming from? I want to be fair but accurate when adressing the measurement of a destruction of a malignant lesion but I don't see anything published (aside from this one source) that talks about 'after curettment'. Thanks for your help. Judy