How To Use CPT Code 17274

CPT code 17274 describes the destruction of a malignant lesion on the scalp, neck, hands, feet, or genitalia using various techniques such as laser surgery, electrosurgery, cryosurgery, chemosurgery, or surgical curettement. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 17274?

CPT 17274 is used to describe the destruction of a malignant lesion on the scalp, neck, hands, feet, or genitalia. The lesion must have a diameter between 3.1 cm and 4.0 cm. The procedure involves using techniques such as laser surgery, electrosurgery, cryosurgery, chemosurgery, or surgical curettement to remove the malignant lesion.

2. Official Description

The official description of CPT code 17274 is: ‘Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia lesion diameter 3.1 to 4.0 cm.’

3. Procedure

When performing CPT 17274, the healthcare provider begins by appropriately prepping the patient. They may choose to administer anesthesia, such as local anesthesia, to ensure the patient’s comfort during the procedure. The provider then proceeds to destroy the malignant lesion, which is between 3.1 cm and 4.0 cm in diameter, on the scalp, neck, hands, feet, or genitalia. Various techniques can be used for lesion destruction, including laser surgery, electrosurgery, cryosurgery, chemosurgery, or surgical curettement. For example, the provider may expose the targeted lesion to a laser beam, high-frequency electrical current, chemical agents like trichloroacetic acid or hydroxy acid, or use liquid nitrogen or a surgical curette to remove the lesion.

4. Qualifying circumstances

CPT 17274 is applicable when a patient has a malignant lesion on the scalp, neck, hands, feet, or genitalia with a diameter between 3.1 cm and 4.0 cm. The lesion must be confirmed as cancerous and capable of spreading if left untreated. The procedure should be performed by a qualified healthcare professional who is experienced in using the specific techniques required for lesion destruction.

5. When to use CPT code 17274

CPT code 17274 should be used when a healthcare professional performs the destruction of a malignant lesion on the scalp, neck, hands, feet, or genitalia with a diameter between 3.1 cm and 4.0 cm. It is important to ensure that the lesion meets the specified size criteria and is confirmed as cancerous. If the lesion’s diameter falls outside the specified range, a different CPT code should be used.

6. Documentation requirements

To support a claim for CPT 17274, the healthcare professional must document the following information:

• Patient’s diagnosis and confirmation of a malignant lesion
• Location of the lesion (scalp, neck, hands, feet, or genitalia)
• Diameter of the lesion (between 3.1 cm and 4.0 cm)
• Technique used for lesion destruction (laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement)
• Anesthesia administered, if applicable
• Any complications or additional procedures performed
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT 17274, ensure that the procedure meets the specific criteria outlined in the code description. It is important to accurately document the lesion’s diameter, location, and the technique used for destruction. CPT code 17274 should not be reported if other destruction procedures on malignant lesions of the integumentary system (CPT codes 17260-17286) have already been performed in the previous seven days. Additionally, consider the use of modifiers when appropriate, such as modifier 26 for professional component billing or modifier TC for technical component billing.

8. Historical information

CPT 17274 was added to the Current Procedural Terminology system on January 1, 1992. There have been no updates or changes to the code since its addition.

9. Similar codes to CPT 17274

Five similar codes to CPT 17274 include:

• CPT 17270: Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia lesion diameter 0.5 cm or less
• CPT 17271: Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia lesion diameter 0.6 to 1.0 cm
• CPT 17272: Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia lesion diameter 1.1 to 2.0 cm
• CPT 17273: Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia lesion diameter 2.1 to 3.0 cm
• CPT 17276: Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia lesion diameter over 4.0 cm

9. Examples

1. A dermatologist using laser surgery to destroy a 3.5 cm malignant lesion on a patient’s scalp.
2. An oncologist performing electrosurgery to remove a 3.2 cm malignant lesion on a patient’s neck.
3. A plastic surgeon utilizing cryosurgery to treat a 3.8 cm malignant lesion on a patient’s hand.
4. A gynecologist performing chemosurgery to remove a 3.6 cm malignant lesion on a patient’s genitalia.