Finding the right code for lesion destruction is not easy. The codes are distributed in the CPT^® book in the integumentary, digestive, male genital system, female genital system, and eye and ocular systems.

Some of the codes are selected by the method of destruction and some are not.  Some of the codes are selected based on the number of lesions; some based on whether the lesions are simple or extensive and some based on size. In order to select the code, the type of lesion must be known.

It is anything but simple.  I’ve summarized it here and created a chart that I hope helps.

I’ve included information about the use of Modifier 58 at the end of this post. And here are some additional articles on minor surgical procedures,

Coding for destruction of benign and pre-malignant lesions

Patients rarely present with the chief complaint saying, “I’m here to have this lesion destroyed.”  A patient might say, “This thing is bothering me.  Can you get rid of it?” Or the more savvy might add, “Can you freeze this wart on my knee?”

CPT^® describes destruction as:

“Ablation of benign, pre-malignant or malignant tissues by any method, with or without curettement, including local anesthesia and not usually requiring closure.”

When CPT^® says “with or without” in a definition it means you aren’t required to do it and you don’t get paid more if you do.