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17260 Total Treatment diameter vs. lesion size? HELP

Help! I have a dermatology provider who is always billing for malignant destruction lesions. She will document in her note something like this:

The lesion was then prepped with chlorhexidine, and anesthetized with buffered 1 % lidocaine with epinephrine, followed by electrodesiccation and curettage 3 times, achieving 4 mm margins, giving total treatment diameter of 3.3 cm.

I know margins are included per the excision codes (114xx, 116xx) but I have never heard of anyone billing a margin for a destruction (same as a wart)

Is "total treatment area" justifiable as a lesion size or is it only appropriate to bill for the actual size of the lesion only? I’m getting push back from the provider but compliance agrees with us.
CPT assist also states lesion size only and no margins.

Anyone else have any thoughts or solutions

Thanks!

Medical Billing and Coding Forum

Size matters 11042? 24.0 cm x 13.5 cm x 2.8 cm

Hopefully you can help.

If your doctor states the following 24.0 cm x 13.5 cm x 2.8 cm non-infected ulceration involving the skin and subcutaneous tissue of the plantar lateral aspect of the thigh.

Do you multiply all these together, 24.0 cm x 13.5 cm x 2.8 cm = 907sqcm? Or do you just grab the highest, for example 24.0cm x 2.8cm = 67.2cm

The 907 seems kind of high..

Medical Billing and Coding Forum