Summary & Overview
CPT 17262: Destruction of Malignant Lesion, Trunk/Arms/Legs 1.1–2.0 cm
CPT code 17262 covers the destruction of malignant cutaneous lesions on the trunk, arms, or legs measuring 1.1 cm to 2.0 cm in diameter, using methods such as chemosurgery, cryosurgery, electrosurgery, or comparable destructive techniques. This code is important for clinicians and billing professionals because it defines a specific lesion size range and scope of service that influences coding accuracy, coverage determinations, and claims adjudication on a national level. Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn the clinical context for when 17262 is used, the typical settings where the service is performed, and the payer landscape that commonly adjudicates these services. The publication provides benchmarks and policy-relevant observations for nationwide practice, highlights differences in payer coverage language and prior authorization trends where available, and outlines common billing considerations tied to lesion size and technique. The content is intended to support accurate coding, efficient claims submission, and informed payer engagement for services involving malignant lesion destruction on the trunk, arms, or legs.
Billing Code Overview
CPT code 17262 describes the 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 specifically applies when the malignant lesion measures 1.1 cm to 2.0 cm in diameter.
Service type: Lesion destruction (malignant), non-excisional operative/dermatologic procedure
Typical site of service: Outpatient clinic or physician office; ambulatory surgical center; dermatology practice
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 67-year-old patient presents to an outpatient dermatology clinic with a biopsy-confirmed cutaneous malignant lesion on the forearm measuring approximately 1.5 cm in greatest diameter. The lesion is shallow and well-circumscribed, with histology consistent with cutaneous squamous cell carcinoma. The dermatologic surgeon schedules a lesion destruction appointment using cryosurgery or electrosurgery in the procedure suite. Pre-procedure steps include verification of the biopsy result, informed consent, review of anticoagulation status, and marking and photographing the lesion. Local anesthesia is administered, the lesion is destroyed using the selected modality, and hemostasis achieved. Post-procedure instructions are provided for wound care and signs of infection, and follow-up for surveillance or additional excision is arranged if margins or depth require further management. Typical site of service is an outpatient dermatology clinic or ambulatory surgery center. Service type is minor surgical destruction of a malignant skin lesion on the trunk, arms, or legs with lesion diameter between 1.1 cm and 2.0 cm, corresponding to code 17262.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure | Use when a distinct E/M visit is performed and documented on the same day as 17262 (e.g., pre-procedure evaluation requiring medical decision-making beyond routine procedure prep). |
52 | Reduced services | Use when the procedure is partially reduced or not completed as originally planned (e.g., incomplete lesion destruction due to patient intolerance). |
53 | Discontinued procedure | Use when the procedure is started but terminated for reasons such as adverse reaction or medical necessity before completion. |
59 | Distinct procedural service | Use to indicate a procedural service is distinct from other services performed on the same day (e.g., separate lesion destruction at a different anatomic site not ordinarily bundled). |
51 | Multiple procedures | Use when multiple procedures are performed at the same session; report the most significant procedure full and append 51 to lesser procedures as payer guidance requires. |
26 | Professional component | Use if reporting only the professional component of a service that has both professional and technical components (rare for 17262; included for completeness if applicable). |
TC | Technical component | Use if reporting only the technical component of a globally-billed service (not commonly used for 17262). |
59 | Distinct procedural service | (Note: 59 already listed above; duplicate entries omitted in clinical table to maintain relevance.) |
50 | Bilateral procedure | Use when the same procedure is performed bilaterally and payer requires coding with bilateral modifier (rare for trunk/arms/legs but applicable for symmetric paired sites). |
22 | Increased procedural services | Use when work required is substantially greater than typical for 17262 and documentation supports unusual effort or complexity. |
24 | Unrelated E/M service by the same physician during a postoperative period | Use when an unrelated E/M occurs during a global postoperative period for a prior procedure unrelated to the lesion destruction. |
57 | Decision for surgery | Use when E/M on the day leads to the decision for a major surgery later (not commonly used for minor skin destruction; included only if clinical workflow supports). |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207N00000X | Dermatology | Dermatologists commonly perform lesion destruction using cryo-, electro-, or chemosurgery. |
208D00000X | Mohs Micrographic Surgery | Physicians specializing in skin cancer surgery may evaluate and manage malignant skin lesions and determine appropriate destruction vs excision. |
207P00000X | Family Medicine | Primary care physicians in some settings perform minor skin lesion destructions in outpatient clinics. |
261Q00000X | Surgical Oncology | Surgical oncologists manage malignant skin lesions when coordination of care or oncologic control is needed. |
163W00000X | Physician Assistant | PAs frequently assist or perform lesion destruction under supervising physician in clinic or ASC settings. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
C44.112 | Squamous cell carcinoma of skin of left forearm | Common malignant cutaneous diagnosis treated with lesion destruction when appropriate for size and depth. |
C44.111 | Squamous cell carcinoma of skin of right forearm | Same clinical relevance for contralateral site; guides site-specific coding and documentation. |
C44.219 | Squamous cell carcinoma of skin of unspecified arm | Used when laterality or exact location is not specified but malignant lesion is on an arm. |
C43.62 | Malignant melanoma of scalp and neck, other | Melanoma typically requires excision rather than destruction; included when initial management decisions consider lesion type. |
D04.12 | Carcinoma in situ of skin of forearm | In situ lesions may be managed with destructive techniques when appropriate. |
C44.312 | Basal cell carcinoma of skin of left lower leg | Basal cell carcinoma on the leg within the 1.1–2.0 cm size range may be treated with destructive modalities depending on clinical judgment. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
11102 | Tangential biopsy of skin (shave), single lesion | Often performed prior to 17262 for diagnostic confirmation of a suspicious malignant lesion. |
11100 | Tangential biopsy of skin (shave), single lesion | Alternative biopsy technique used for diagnosis before definitive destructive therapy. |
11305 | Shaving of benign lesion(s), trunk, arms or legs; single lesion, diameter 0.6 cm or less (includes simple closure when performed) | May be performed for diagnostic or therapeutic removal of smaller benign lesions; distinct from malignant lesion destruction coded with 17262. |
11600 | Excision, malignant lesion including margins, trunk, arms or legs; excised diameter 0.5 cm or less | Surgical excision codes are an alternative definitive treatment to 17262 when lesion depth or margins require excision rather than destruction. |
12051 | Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities; 2.6 cm to 7.5 cm | May be reported when lesion destruction or accompanying excision requires intermediate wound repair. |
99213 | Office or other outpatient visit for evaluation and management | Common E/M code for pre- or post-procedure evaluation on the same day; report with modifier 25 when appropriate. |