How To Use CPT Code 17286
CPT 17286 describes the destruction of a malignant lesion on the face, ears, eyelids, nose, lips, or mucous membrane that is over 4.0 cm in diameter. 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 17286?
CPT 17286 is used to describe the destruction of a malignant lesion on the face, ears, eyelids, nose, lips, or mucous membrane that is larger than 4.0 cm in diameter. This code is used when a healthcare provider uses techniques such as laser surgery, electrosurgery, cryosurgery, chemosurgery, or surgical curettement to remove the lesion.
2. Official Description
The official description of CPT code 17286 is: ‘Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane lesion diameter over 4.0 cm.’
3. Procedure
When performing CPT 17286, the healthcare provider first assesses the patient’s condition and determines the need for lesion destruction. The provider may choose to administer anesthesia, such as local anesthesia, to ensure the patient’s comfort during the procedure. The provider then uses techniques such as laser surgery, electrosurgery, cryosurgery, chemosurgery, or surgical curettement to destroy the malignant lesion. These techniques involve exposing the lesion to a laser beam, high-frequency electrical current, chemical agents, liquid nitrogen, or scraping the lesion with a surgical curette. The procedure is performed on the face, ears, eyelids, nose, lips, or mucous membrane and is specifically used for lesions larger than 4.0 cm in diameter.
4. Qualifying circumstances
CPT 17286 is used for patients with a malignant lesion on the face, ears, eyelids, nose, lips, or mucous membrane that is larger than 4.0 cm in diameter. The lesion must be confirmed as malignant, meaning it is cancerous and has the potential to spread and cause harm if left untreated. The procedure must be performed by a qualified healthcare provider who is trained in the specific techniques used for lesion destruction.
5. When to use CPT code 17286
CPT code 17286 should be used when a healthcare provider performs the destruction of a malignant lesion on the face, ears, eyelids, nose, lips, or mucous membrane that is larger than 4.0 cm in diameter. It is important to accurately measure the size of the lesion to determine if it meets the criteria for this code. If the lesion is smaller than 4.0 cm in diameter, a different CPT code should be used.
6. Documentation requirements
To support a claim for CPT 17286, the healthcare provider must document the following information:
- Patient’s diagnosis and confirmation of a malignant lesion
- Size of the lesion, confirming it is larger than 4.0 cm in diameter
- Specific technique used for lesion destruction (laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement)
- Date of the procedure
- Any anesthesia administered
- Progress made during the procedure and any follow-up care planned
- Signature of the healthcare provider performing the procedure
7. Billing guidelines
When billing for CPT 17286, ensure that the procedure meets the criteria of a malignant lesion on the face, ears, eyelids, nose, lips, or mucous membrane that is larger than 4.0 cm in diameter. It is important to accurately measure the size of the lesion and document it in the medical record. CPT code 17286 should not be reported if other destruction procedures on malignant lesions of the integumentary system (CPT codes 17260-17285) have already been performed in the previous seven days. It is also important to follow any specific guidelines provided by insurance payers regarding the use of this code.
8. Historical information
CPT 17286 was added to the Current Procedural Terminology system on January 1, 2002. Prior to that, there was no specific code for the destruction of a malignant lesion on the face, ears, eyelids, nose, lips, or mucous membrane that is larger than 4.0 cm in diameter.
9. Examples
- A dermatologist using laser surgery to destroy a malignant lesion on a patient’s nose that is larger than 4.0 cm in diameter.
- A plastic surgeon performing electrosurgery to remove a malignant lesion on a patient’s eyelid that is larger than 4.0 cm in diameter.
- An otolaryngologist using cryosurgery to treat a malignant lesion on a patient’s ear that is larger than 4.0 cm in diameter.
