CPT® Code 0658T

Official Description

Electrical impedance spectroscopy of 1 or more skin lesions for automated melanoma risk score

Common Language Description

Electrical impedance spectroscopy (EIS) is a diagnostic procedure utilized to assess skin lesions that are suspected to be melanoma. This technique involves the application of alternating electrical currents at various frequencies to measure the resistance of the tissue. The underlying principle of EIS is based on the fact that human tissues exhibit different electrical properties depending on their cellular structure and state. By analyzing these properties, EIS can help categorize the cellular structure of the lesion, which aids in the detection of potential malignancies. The procedure employs a handheld device equipped with a light beam that penetrates the skin, capturing images of the lesion for further analysis. These images are processed by specialized computer software that calculates a melanoma risk score by evaluating the lesion's cellular characteristics, including composition, shape, size, and membrane structure. The lesions examined typically range from 2 to 20 millimeters in size and must be intact, free from hair or scars. EIS involves taking measurements at 35 different frequencies and four depth settings to ensure comprehensive data collection. Prior to the examination of the lesion, a baseline measurement is taken from a nearby area of normal, healthy skin. It is important to note that while EIS provides valuable information regarding the risk of melanoma, it is not intended to confirm a melanoma diagnosis; rather, it serves as an adjunct tool for physicians trained in skin cancer diagnosis when considering further actions such as excision.

1. Indications

Electrical impedance spectroscopy (EIS) is indicated for use in the evaluation of skin lesions that are clinically suspicious for melanoma. The procedure is particularly relevant for lesions that exhibit atypical characteristics, which may warrant further investigation. The following conditions may prompt the use of EIS:

Suspicious Skin Lesions Lesions that display irregular borders, varied colors, or asymmetry, which are common indicators of potential melanoma.
Monitoring of Existing Lesions Lesions that have changed in appearance or have been previously identified as atypical may require further assessment to determine the risk of malignancy.
Assessment Prior to Excision EIS can provide additional information to assist physicians in making informed decisions regarding the excision of suspicious lesions.

2. Procedure

The procedure for electrical impedance spectroscopy involves several key steps to ensure accurate assessment of the skin lesions. The following outlines the procedural steps:

Step 1: Preparation The clinician prepares the patient by explaining the procedure and ensuring that the lesion to be examined is accessible. The area surrounding the lesion is cleaned to minimize any interference during the measurement.
Step 2: Baseline Measurement A test measurement is performed on a nearby area of normal, healthy skin. This baseline data is crucial for comparison with the measurements taken from the suspicious lesion.
Step 3: Application of EIS Device The handheld EIS device is positioned over the lesion. The device emits alternating electrical currents at various frequencies, ranging from 1 kHz to 2.5 MHz, to measure the tissue's electrical resistance.
Step 4: Data Collection The device collects data by taking measurements at 35 different frequencies and four depth settings. This comprehensive approach allows for a detailed analysis of the lesion's cellular structure.
Step 5: Image Capture and Analysis As the electrical signal is applied, images of the lesion are captured and transmitted to the computer software. The software analyzes these images to classify the lesion and calculate a risk score based on the degree of atypia.

3. Post-Procedure

After the electrical impedance spectroscopy procedure, the clinician will review the risk score generated by the software. This score provides valuable information regarding the likelihood of malignancy in the examined lesion. The clinician may discuss the findings with the patient and determine the next steps, which could include monitoring the lesion, scheduling follow-up appointments, or considering excision based on the risk assessment. It is important to note that while EIS offers additional insights, it does not serve as a definitive diagnostic tool for melanoma. Therefore, any decisions regarding treatment or further evaluation will be made in conjunction with clinical judgment and other diagnostic findings.

Short Descr	ELEC IMPD SPECTRSC 1+SKN LES
Medium Descr	ELECTRICAL IMPEDENCE SPECTROSCOPY 1+SKIN LESIONS
Long Descr	Electrical impedance spectroscopy of 1 or more skin lesions for automated melanoma risk score
Status Code	Carriers Price the Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	0 - Physician Service Code
Multiple Procedures (51)	2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50)	0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Procedure or Service, Not Discounted when Multiple
Berenson-Eggers TOS (BETOS)	none
MUE	1

Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).

Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.