Destruction and Mohs: Coding AKs, Benign Lesions, and Micrographic Surgery
Lesion destruction and Mohs micrographic surgery are counted and staged in specific ways — getting the counts and site families right is what drives the claim.
Destruction is split by lesion type
- Premalignant (actinic keratoses): 17000 (first lesion), +17003 (2nd–14th, each), 17004 (15 or more, a single all-inclusive code)
- Benign: 17110 (up to 14 lesions), 17111 (15 or more)
- Malignant: 17260–17286, by site and lesion diameter
Count carefully: for AKs, 15+ lesions flips to the single 17004 code rather than stacking add-ons.
Mohs is stage-based, by anatomic family
- 17311 / +17312 — head, neck, hands, feet, genitalia: first stage / each additional stage
- 17313 / +17314 — trunk, arms, legs: first stage / each additional stage
- +17315 — each additional block after the first five, any stage
Mohs requires the physician to act as both surgeon and pathologist — that dual role is a documentation prerequisite. A biopsy on the same day to confirm the diagnosis before Mohs may be separately reportable with a modifier; reconstruction after Mohs is coded separately under the usual repair/flap hierarchy.
Clinical Capture counts lesions into the correct destruction tier and assembles the stage-and-site Mohs coding, keeping the separately-reportable repair distinct.
This article is educational and not coding, billing, or legal advice. Always verify codes and values against the current CPT®, ICD-10-CM, and CMS Physician Fee Schedule, follow NCCI edits and payer policy, and confirm with a certified coder before submitting a claim. Document only work that was actually performed.