Summary & Overview
CPT 17260: Destruction of Malignant Lesion ≤0.5 cm on Trunk/Arms/Legs
CPT code 17260 documents the destruction of a malignant skin lesion on the trunk, arms, or legs when the lesion is 0.5 cm or less in diameter. This code captures a common, low-complexity dermatologic procedure used to treat small cutaneous malignancies in outpatient settings. Nationally, accurate use of this code matters for clinical documentation, facility and professional billing, and monitoring utilization of minor dermatologic interventions for skin cancer management.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for use of 17260, the typical sites of service where the procedure is performed, and the categories of documentation and coding considerations that affect claim submission and coverage review. The publication also outlines benchmarking topics and policy updates relevant to minor skin lesion destruction, along with payer-specific coverage patterns and common administrative issues to watch.
This summary provides clinicians, coding professionals, and policy analysts with a practical reference to understand when to select CPT code 17260, what clinical scenario it represents, and which national payers commonly adjudicate claims for this service. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 17260 describes destruction of a malignant lesion located on the trunk, arms, or legs using techniques such as chemosurgery, cryosurgery, electrosurgery, or other destructive methods. The code applies when the lesion measures 0.5 cm or less in diameter.
Service Type: Lesion destruction / minor dermatologic procedure
Typical Site of Service: Outpatient clinic, dermatology office, ambulatory surgical center, or other outpatient settings
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to an outpatient dermatology or primary care clinic with a small suspicious or biopsy-proven malignant cutaneous lesion on the trunk, arm, or leg. The lesion measures 0.5 cm or less in greatest diameter and is amenable to destructive techniques such as cryosurgery, electrosurgery, chemosurgery, curettage with cautery, or topical chemical agents. The clinical workflow includes history and focused skin exam, lesion measurement and photographic documentation, informed consent discussing options and risks, local anesthesia as needed, lesion destruction using the chosen modality, hemostasis, wound care instructions, and documentation of pathology if prior biopsy performed. Typical follow-up may be arranged to assess healing and recurrence. Typical sites of service are outpatient dermatology clinic, ambulatory surgery center, or physician office procedure room. Common payors include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Physician or other qualified health care professional service | Use when service represents the physician's typical level of service. |
22 | Increased procedural services |