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Assign Integumentary Excision Codes - Certified Professional Coder CPC

  1. A surgeon excises a 1.5 cm malignant lesion from the lower eyelid with a 0.2 cm margin, yielding a 1.9 cm excised diameter. Which CPT® code covers malignant lesion excision on the eyelids with excised diameter 1.1–2.0 cm?
    Answer: 11641 CPT® 11641 covers excision of malignant lesion, face, ears, eyelids, nose, and/or lips, excised diameter 1.1–2.0 cm. The lower eyelid falls in the facial anatomical grouping. The excised diameter of 1.9 cm falls in the 1.1–2.0 cm range, making 11641 the correct code. Code 11640 covers 0.5 cm or less; 11642 covers 2.1–3.0 cm; 11643 covers 3.1–4.0 cm.
  2. A pathologist examines an excised benign skin lesion and confirms a diagnosis of intradermal nevus of the trunk. Which ICD-10-CM code covers benign melanocytic nevus of the trunk?
    Answer: D22.5 ICD-10-CM D22.5 covers melanocytic nevi of the trunk. Code D22.4 covers melanocytic nevi of the scalp and neck; D22.9 covers melanocytic nevi, unspecified; D22.0 covers melanocytic nevi of the lip. The D22 category covers benign melanocytic nevi (moles) with site-specific subcategories. The trunk site designation (D22.5) is required when the lesion is on the torso. Intradermal nevus is classified as a benign melanocytic nevus.
  3. A physician removes 12 skin tags from the neck and trunk area. Which CPT® code covers removal of up to 15 skin tags?
    Answer: 11200 CPT® 11200 covers removal of skin tags, multiple fibrocutaneous tags, any area, up to and including 15 lesions. Add-on code 11201 covers each additional 10 lesions beyond the first 15. For 12 skin tags, 11200 is the only code required since 12 is within the 15-lesion threshold. Code 11300 covers shave removal, which is a different procedure type. Skin tag removal (11200) is distinct from shave removal (11300 series) in both technique and code selection.
  4. A surgeon excises a 1.8 cm benign lesion from the patient's back. The excision includes a 0.2 cm margin on each side. What measurement is used to select the CPT® excision code?
    Answer: The excised diameter including the narrowest margin (2.2 cm total) For CPT® excision coding, the code is selected based on the excised diameter — the lesion diameter plus the narrowest margin on each side. For a 1.8 cm lesion with 0.2 cm margins on each side: 1.8 + 0.2 + 0.2 = 2.2 cm excised diameter. This measurement is used to select the appropriate size-based excision code. The widest margin is not used — only the narrowest margin on each side contributes to the excised diameter calculation.
  5. A surgeon performs an incision and drainage (I&D) of a simple cutaneous abscess on the right forearm. Which CPT® code covers incision and drainage of a simple abscess?
    Answer: 10060 CPT® 10060 covers incision and drainage of abscess, simple or single. Code 10061 covers complicated I&D (multiple loculations or extensive involvement); 10120 covers incision and removal of a foreign body, subcutaneous tissue; 10180 covers complex I&D of a postoperative wound infection; 10080 covers I&D of a pilonidal cyst, simple. Simple cutaneous abscess I&D is specifically coded with 10060.
  6. A dermatologist destroys 20 actinic keratoses in a single session using cryotherapy. Which CPT® code(s) are reported?
    Answer: 17004 CPT® 17004 covers destruction of premalignant lesions, including actinic keratoses, 15 or more lesions in a single session. When 15 or more actinic keratoses are destroyed, 17004 is reported alone — it is not used in combination with 17000 and 17003. For 14 or fewer lesions, 17000 (first lesion) and 17003 (each additional through the 14th) are used. At 15 or more, 17004 replaces both prior codes and covers the entire session as a single unit.
  7. A surgeon performs a wide excision of a primary malignant melanoma of the back with 2 cm margins. The total excised diameter is 5.5 cm. Which CPT® code covers malignant lesion excision on the trunk with excised diameter over 4.0 cm?
    Answer: 11606 CPT® 11606 covers excision of malignant lesion, trunk, arms, and/or legs, excised diameter over 4.0 cm. Code 11604 covers 3.1–4.0 cm; 11605 covers 4.1–5.0 cm on the trunk — wait, the trunk malignant excision series (11600–11606) uses 11606 for over 4.0 cm, not 11605. Code 11646 is for face/ears/eyelids/nose/lips over 4.0 cm. For a 5.5 cm excised diameter on the trunk, 11606 is the correct code.
  8. A dermatologist performs destruction of a 1.5 cm malignant lesion on the trunk using laser surgery (not Mohs surgery). Which CPT® code range covers destruction of malignant lesions?
    Answer: 17260-17286 CPT® codes 17260-17286 cover destruction of malignant lesions using various techniques, including cryosurgery, electrosurgery, laser, and photodynamic therapy. Code selection within this range is based on anatomical location and lesion size (e.g., 17270 for scalp/neck/hands/feet/genitalia, 17260 for trunk/arms/legs). Code 17311-17315 covers Mohs micrographic surgery, which is a staged excision-with-microscopy technique — not simple destruction. Code 17000-17004 covers premalignant (actinic keratosis) destruction; 17110-17111 covers benign lesion destruction.
  9. A physician destroys 20 benign warts in a single session using cryotherapy. Which CPT® code covers destruction of 15 or more benign lesions in one session?
    Answer: 17111 CPT® 17111 covers destruction of benign lesions, 15 or more lesions, in a single session. Code 17110 covers 1-14 benign lesions; 17000 covers the first premalignant actinic keratosis; 17003 is the add-on for each additional actinic keratosis. At 15 or more benign lesions, 17111 replaces 17110 and covers the entire session as a single code. The benign lesion threshold (17110 vs. 17111) mirrors the actinic keratosis threshold (17000/17003 vs. 17004).
  10. A surgeon excises a 0.7 cm benign lesion from the dorsum of the right hand. Which CPT® code range covers benign lesion excision on the scalp, neck, hands, feet, and/or genitalia?
    Answer: 11420-11426 CPT® 11420-11426 covers excision of benign lesions on the scalp, neck, hands, feet, and genitalia. Code 11400-11406 covers trunk, arms, and legs; 11440-11446 covers face, ears, eyelids, nose, lips, and mucous membranes; 11450-11471 covers skin and subcutaneous tissue of the axillae, inguinal regions, and related areas (e.g., for hidradenitis). The hand falls in the scalp/neck/hands/feet/genitalia grouping (11420-11426). For a 0.7 cm lesion on the hand, 11421 (0.6-1.0 cm) is the specific code.
  11. A surgeon excises a 0.8 cm malignant melanoma from the left cheek with 0.3 cm margins all around. The excised diameter is 1.4 cm. Which CPT® code covers malignant lesion excision on the face with excised diameter 1.1–2.0 cm?
    Answer: 11641 CPT® 11641 covers excision of malignant lesion on the face, ears, eyelids, nose, and/or lips, excised diameter 1.1–2.0 cm. The face falls in the facial anatomical grouping for malignant excision codes (11640–11646). An excised diameter of 1.4 cm falls in the 1.1–2.0 cm range, making 11641 the correct code. Code 11640 covers 0.5 cm or less; 11642 covers 2.1–3.0 cm; 11643 covers 3.1–4.0 cm; 11644 covers over 4.0 cm.
  12. A surgeon excises a benign lesion from the arm and repairs the wound with a simple single-layer closure. How is the simple closure reported?
    Answer: It is included in the benign lesion excision code and not reported separately CPT® excision code descriptors include simple wound closure as an integral component of the excision service. Simple (single-layer) wound closure following benign or malignant lesion excision is not separately reportable. Intermediate or complex closure, however, is separately reportable in addition to the excision code. This is one of the most commonly tested bundling rules in the integumentary section.
  13. A surgeon excises a 2.3 cm sebaceous cyst from the scalp, requiring layered closure of the galea and skin. What CPT® codes are reported?
    Answer: 11423 and 12032 CPT® 11423 covers excision of benign lesion on the scalp/neck/hands/feet/genitalia, excised diameter 2.1-3.0 cm. A 2.3 cm lesion on the scalp falls within this range. When excision requires intermediate closure (layered closure), the closure code (12032 — intermediate repair, scalp, 2.6-7.5 cm) is separately reportable in addition to the excision. Simple closure is bundled into the excision code; intermediate or complex closure is separately billable.
  14. A surgeon excises a 0.4 cm benign lesion from the right ear. The ear falls in which CPT® anatomical grouping for benign lesion excision?
    Answer: Face, ears, eyelids, nose, lips (11440–11446) The ear is part of the face, ears, eyelids, nose, lips, and/or mucous membranes anatomical grouping for benign lesion excision (11440–11446). Code 11440 covers 0.5 cm or less; 11441 covers 0.6–1.0 cm; 11442 covers 1.1–2.0 cm. For a 0.4 cm lesion on the ear, 11440 is the specific code. Correctly assigning the lesion to its anatomical grouping is essential for accurate excision code selection.
  15. A surgeon biopsies a suspicious skin lesion using a 3 mm punch technique with simple closure. Which CPT® code covers a punch biopsy of the skin, first lesion?
    Answer: 11104 CPT® 11104 covers punch biopsy of skin, subcutaneous tissue, and/or mucous membrane, including simple closure when performed, first lesion. Code 11105 is the add-on for each additional punch biopsy lesion. Code 11102 covers tangential (shave-type) biopsy, first lesion; 11106 covers incisional biopsy, first lesion; 11100 is the deleted predecessor code for skin biopsy (replaced by 11102, 11104, and 11106 in 2019). The punch technique specifically maps to 11104, not the tangential or incisional biopsy codes.
  16. A dermatologist performs a shave removal of a 0.6 cm raised benign lesion from the trunk using a scalpel blade. Which CPT® code covers shave removal of a trunk lesion 0.6-1.0 cm in diameter?
    Answer: 11301 CPT® 11301 covers shave removal of epidermal or dermal lesion, single lesion, trunk, arms, or legs, lesion diameter 0.6-1.0 cm. Code 11300 covers 0.5 cm or less; 11302 covers 1.1-2.0 cm; 11303 covers over 2.0 cm. Shave removal codes are based on anatomical site and lesion diameter (not excised diameter, since no formal margin is taken). The trunk/arm/leg grouping uses 11300-11303.
  17. A surgeon excises a 2.5 cm malignant lesion from the left arm, with the total excised diameter including margins measuring 3.2 cm. Which CPT® code covers malignant lesion excision on the trunk/extremities with excised diameter 3.1–4.0 cm?
    Answer: 11604 CPT® 11604 covers excision of malignant lesion on the trunk, arms, and/or legs, excised diameter 3.1–4.0 cm. Code 11601 covers 0.6–1.0 cm; 11602 covers 1.1–2.0 cm; 11603 covers 2.1–3.0 cm. The excised diameter of 3.2 cm falls in the 3.1–4.0 cm range, making 11604 the correct code. Code selection is based on the excised diameter (lesion plus narrowest margin), not the lesion diameter alone.
  18. A surgeon performs excision of a pilonidal cyst with simple marsupialization. Which CPT® code covers excision of a pilonidal cyst, simple?
    Answer: 11770 CPT® 11770 covers excision of pilonidal cyst or sinus, simple. Code 11771 covers excision of pilonidal cyst with extensive primary closure; 11772 covers excision with complicated primary closure requiring flap or graft; 10081 covers incision and drainage of pilonidal cyst, complicated. The three pilonidal cyst excision codes (11770-11772) are differentiated by the complexity of the closure technique, not by cyst size. Simple excision without extensive or complicated closure is 11770.
  19. A physician destroys 8 flat warts (verruca plana) on the back of the hand using liquid nitrogen. Which CPT® code covers destruction of benign lesions other than skin tags, up to 14 lesions?
    Answer: 17110 CPT® 17110 covers destruction of benign lesions including warts (verruca), other than cutaneous vascular proliferative lesions, 1-14 lesions. Code 17111 covers 15 or more benign lesions; 17000 covers premalignant lesions (actinic keratoses); 17003 is the add-on for additional actinic keratoses. For benign lesions such as warts, 17110 (1-14 lesions) or 17111 (15 or more) applies — not the actinic keratosis codes. Eight flat warts falls within the 1-14 range, making 17110 correct.
  20. A surgeon performs excision of a benign lesion of the face measuring 0.7 cm excised diameter. Which CPT® code covers benign lesion excision on the face with excised diameter 0.6-1.0 cm?
    Answer: 11441 CPT® 11441 covers excision of benign lesion, face, ears, eyelids, nose, lips, and/or mucous membranes, excised diameter 0.6-1.0 cm. Code 11440 covers face/ears/eyelids/nose/lips, 0.5 cm or less; 11400 covers trunk/arms/legs, 0.5 cm or less; 11420 covers scalp/neck/hands/feet/genitalia, 0.5 cm or less. A 0.7 cm facial lesion falls in the 0.6-1.0 cm range of the facial grouping, making 11441 the correct code.

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