In a tissue mutation identification by sequencing for suspected melanoma, which ICD-10-CM and CPT codes are used?

In a tissue mutation identification by sequencing for suspected melanoma, which ICD-10-CM and CPT codes are used?

• A. D03.39, 83904
• B. D03.39, 83905
• C. D03.3, 83904
• D. D03.49, 83904

Answer: (A)

When coding this scenario, you bill the diagnosis prompting the test with an ICD-10-CM code and the laboratory test itself with a CPT code. For a tissue mutation identification by sequencing performed to evaluate a suspicious melanoma where the site isn’t specified, the diagnosis fits melanoma in situ, unspecified site, coded as D03.39. The lab test described—mutation analysis by sequencing to identify a tissue mutation—maps to a single-gene sequencing mutation analysis, billed as CPT 83904. The alternative CPT 83905 would be used only if sequencing for multiple genes or a broader panel were performed, which isn’t indicated here. If a specific site were documented, a different D03.x code might be used; if the melanoma were invasive, a different cancer code would apply.

When coding this scenario, you bill the diagnosis prompting the test with an ICD-10-CM code and the laboratory test itself with a CPT code. For a tissue mutation identification by sequencing performed to evaluate a suspicious melanoma where the site isn’t specified, the diagnosis fits melanoma in situ, unspecified site, coded as D03.39. The lab test described—mutation analysis by sequencing to identify a tissue mutation—maps to a single-gene sequencing mutation analysis, billed as CPT 83904. The alternative CPT 83905 would be used only if sequencing for multiple genes or a broader panel were performed, which isn’t indicated here. If a specific site were documented, a different D03.x code might be used; if the melanoma were invasive, a different cancer code would apply.