Electrodessication with curettage (ED&C) Measurement

Question:

Good Afternoon, please clarify how lesions are measured for the destruction of malignant lesion codes 17260-17286. Is the code selection based on the size of the lesion before or after the curettage?

We are unable to find guidance from AMA or CMS. Our provider is stating that it is based on the size after curettage and basing it on this article at this link:
www.hmpgloballearningnetwork.com/site/thederm/site/cathlab/event/size-matters#:~:text=Size After Curettage, but Before,a 1.5 cm/d measurement.

Answer:

For destruction of malignant lesion codes 17260-17286, the code selection is based on the size of the lesion AFTER curettage, but BEFORE electrodesiccation.

Destruction of malignant lesions (CPT codes 17260 to 17286) is selected based on the lesion size after curettage, but before electrodesiccation. This timing is important because:

1. Initial clinical appearance may be misleading - The lesion might appear to be a certain size clinically, but curettage helps visualize the true extent of the malignant tissue.

2. Curettage reveals actual lesion boundaries - After curettage, the physician can better assess the actual diameter of the lesion that needs to be destroyed.

3. Before electrodesiccation - The measurement should be taken after curettage but before the electrodesiccation (destruction) process begins, as the destruction process itself would alter the lesion size.

*This response is based on the best information available as of 11/20/25.

Tendon Repairs

Question:

Can you provide additional clarification regarding correct selection for your tendon repair? AMA states code selection should be where the tendon is repaired not the originating area of the tendon.

Answer:

We appreciate you reaching out. AMA guidance is correct for repairing of tendons.  CPT code selection for tendon repairs with grafts are based on the recipient site not the donor site. 

*This response is based on the best information available as of 11/06/25.

Still Unlisted?

Question:

I hope KZA can provide clarification. In the past, when coding EDAS for treatment of MoyaMoya disease, I used unlisted code 64999 compared to 61711. I have recently seen articles using 61711 only. Which would be the most appropriate code to use?

Answer:

Thank you for asking KZA!

Encephaloduroarteriosynangiosis (EDAS) is an indirect revascularization technique designed to improve blood flow to the brain without directly connecting blood vessels. Because CPT 61711 specifically describes a direct extracranial-to-intracranial arterial anastomosis, this does not accurately reflect EDAS technique.

You have been reporting this correctly. There is no CPT code for this, which is appropriately reported with unlisted CPT 64999.

If you’re seeing 61711 used in articles, it may be due to confusion with direct bypass procedures, such as STA-MCA bypass, which do fall under 61711. For EDAS, however, 64999 remains the most accurate and compliant choice.

*This response is based on the best information available as of 11/06/25.

Reshaping of the Internal Nasal Valve Region

Question:

My physician has started doing repairs for nasal valve collapse using low energy radiofrequency. We have been using the unlisted code 30999. Another coder told me that is no longer the correct code. Can you help?

Answer:

There is a CPT code 30469 for reporting remodeling of the nasal airway using low energy temperature controlled radiofrequency which was previously reported with the unlisted code 30999. 

*This response is based on the best information available as of 11/06/25.

Clarifying +G2211

Question:

My question is whether +G2211 is appropriate for vascular surgeons. Since the code has now been implemented, I’m wondering if it’s considered appropriate for those of us who manage long-term vascular patients over several years to use this add-on code until further guidance or changes occur.

Answer:

The add-on code +G2211 is not restricted by specialty and may be reported by any provider when the visit meets the required criteria. However, many interpretations suggest that the intent of the code is more closely aligned with primary care and the ongoing, relationship-based management of chronic or complex conditions, rather than procedural or single-episode care.

To use +G2211, the encounter must involve an office or outpatient E/M service (99202–99215) and reflect longitudinal or continuous care for a serious or complex condition. Documentation should support that the provider serves as a continuing focal point in the patient’s management and that the care provided extends beyond routine or acute treatment.

Because the code allows interpretive flexibility, its use in procedural specialties may carry a higher risk of audit or scrutiny.

*This response is based on the best information available as of 11/06/25.

Does a Figure-Eight Suture Qualify as Intermediate Repair?

Question:

I was told a figure eight suture is considered intermediate closure. Is this correct?

Answer:

A figure-eight suture is just a closure technique, not a repair classification. The depth of the wound and layers repaired determine whether the closure is coded as simple, intermediate, or complex.

*This response is based on the best information available as of 11/06/25.