icd 10 code for 17110

Full Answer

What does CPT code 17110 mean?

CPT ® Code Set. Code Information. 17110 - CPT® Code in category: Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions.

What is the difference between CPT Code 17003 and 17004?

CPT code 17000 should be reported with one unit of service for destruction of the first lesion; CPT code 17003 should be reported with the units equal to the number of additional lesions from 2 through 14; 17004 should be reported with one unit of service, representing 15 or more lesions and should not be used with 17000 or 17003.

When should the CPT code 11400-11446 be used?

CPT codes 11400-11446 should be used when the excision is a full-thickness (through the dermis) removal of a lesion, including margins, and includes simple (non-layered) closure. Excision is defined as full-thickness (through the dermis) removal of a lesion, including margins, and includes simple (non-layered) closure when performed.

What is the difference between Procedure Code 11201 and 11200?

Procedure code 11200 should be reported with one unit of service. Procedure code 11201 should be reported with units equal to one for each additional group of 10 lesions.

Is 17110 a surgical code?

Formal definitions of the codes are as follows: 17110 – Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular lesions; up to 14 lesions.

Is CPT 17110 covered by Medicare?

CPT 17110 and CPT 17111 may not be reported together. Medicare will not pay for a separate E/M service on the same day dermatologic surgery is performed unless significant and separately identifiable medical services were rendered and clearly documented in the patient's medical record.

Does 17110 need a modifier?

CPT 17110 requires a 10-day post-surgery period, included in the rate, and modifier 25 with grade and management code.

What is the difference between CPT code 17000 and 17110?

17000 is for the first lesion. If up to 14 lesions are fulgerated you would use 17000 (first lesion) AND 17003 (2nd thru 14) and for 15 or more you would only use code 17004. Code 17110 is used just once for up to 14 lesions, if 15 or more then you would use 17111.

Can 17110 be billed alone?

Whether you destroy 1, 7, or 14 lesions, you would only bill a single CPT 17110. If you destroy 15, 18, 25, or 1000 benign lesions (warts), you would only bill a single CPT 17111 (CPT 17110 no longer applies when CPT 17111 takes over).

What is the global period for CPT code 17110?

Many commonly reported procedures in the pediatric office contain 10-day global periods, including wart removal (CPT code 17110), incision and removal of subcutaneous foreign body (CPT code 10120) and nursemaid elbow reduction (CPT code 24640).

Can I bill an office visit and a wart removal?

It is strongly discouraged to bill an office visit in addition to the lesion removal unless the patient is being seen for a chief complaint unrelated to the lesion removal. If an office visit is billed with the same diagnosis, an insurance is very likely to bundle the E&M code, which cannot be billed to the patient.

How do you code skin tag removal?

For removal of skin tags by any method, use codes 11200 and 11201. For the first 15 skin tags removed, use code 11200. For each additional 10 skin tags removed, also report code 11201.

Does CPT code 17000 need a modifier?

Modifier (-59) is used to alert the payer that the services are not related to the biopsy also performed on the same date. The 17000 code is separated from the biopsy charge and is the primary code for the 17003 CPT code so no additional modifier is needed for the charges to process.

What does CPT code 17000 mean?

CPT® Code 17000 in section: Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses)

What is procedure code 11400?

11400. EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR LEGS; EXCISED DIAMETER 0.5 CM OR LESS.

What is procedure code 11420?

CPT® Code 11420 in section: Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia.

What CPT codes are not covered by Medicare?

Certain services are never considered for payment by Medicare. These include preventive examinations represented by CPT codes 99381-99397. Medicare only covers three immunizations (influenza, pneumonia, and hepatitis B) as prophylactic physician services.

How do I know if a CPT is covered by Medicare?

You can also call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048. 3. Call 1-800-MEDICARE to see if they have information on any related local or national coverage policies.

What procedures are not covered by Medicare?

Some of the items and services Medicare doesn't cover include:Long-Term Care. ... Most dental care.Eye exams related to prescribing glasses.Dentures.Cosmetic surgery.Acupuncture.Hearing aids and exams for fitting them.Routine foot care.

Does Medicare pay for 20985?

Codes 20985, 0054T, or 0055T are not covered services and are not separately reimbursable. The following applies to all claim submissions. All coding and reimbursement is subject to all terms of the Provider Service Agreement and subject to changes, updates, or other requirements of coding rules and guidelines.

General Information

CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

CMS National Coverage Policy

CMS Pub.100-02 Medicare Benefit Policy Manual, Chapter 16 - General Exclusions From Coverage, Section §120 - Cosmetic Surgery

Article Guidance

The billing and coding information in this article is dependent on the coverage indications, limitations and/or medical necessity described in the associated LCD L35498 Removal of Benign Skin Lesions. Coding Information Use the CPT code that best describes the procedure, the location and the size of the lesion.

ICD-10-CM Codes that DO NOT Support Medical Necessity

In the absence of signs, symptoms, illness or injury, Z41.1 should be reported, and payment will be denied. (Ref. CMS Pub.100-04 Medicare Claims Processing Manual, Ch. 23 §§10.1-10.1.7)

Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.

Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.

What is the assignment of a diagnosis code?

The assignment of a diagnosis code is based on the provider’s diagnostic statement that the condition exists. The provider’s statement that the patient has a particular condition is sufficient. Code assignment is not based on clinical criteria used by the provider to establish the diagnosis.".

Is DSAP a premalignant lesion?

As far as DSAP, according to medical literature, it is considered a premalignant lesion.

What is the procedure code for a lesion?

1. Use the Procedure code that best describes the procedure, the location and the size of the lesion. If there are multiple lesions, multiple codes from 11300 through 11446 or 17106 through 17111 may be used, but National Correct Coding Initiative guidelines apply for all submitted codes.

What does "appropriate" mean in medical terms?

Appropriate, including the duration and frequency that is considered appropriate for the service, in terms of whether it is: Furnished in accordance with accepted standards of medical practice for the diagnosis or treatment of the patient’s condition or to improve the function of a malformed body member.

What is shaving in medical terms?

According to the American Medical Association Current Procedural Terminology® (AMA CPT), shaving “is the sharp removal by transverse incision or horizontal slicing to remove epidermal and dermal lesions without a full thickness dermal excision. This includes local anesthesia, chemical or electrocauterization of the wound, and does.

Policy

Aetna considers removal of acquired or small (less than 1.5 cm) congenital nevi (moles), cutaneous and subcutaneous neurofibromas, dermatofibromas, dermatosis papulosa nigra, acrochordon (skin tags), pilomatrixomata (slow-growing hard mass underneath the skin that arises from hair follicle matrix cells), sebaceous cysts (pilar and epidermoid cysts), seborrheic keratoses (also known as basal cell papillomas, senile warts or brown warts), or other benign skin lesions, or needle hyfrecation for sebaceous hyperplasia, medically necessary if any of the following criteria is met:.

Background

A skin lesion is a nonspecific term that refers to any change in the skin surface; it may be benign, malignant or premalignant. Skin lesions may have color (pigment), be raised, flat, large, small, fluid filled or exhibit other characteristics.

The above policy is based on the following references

American Academy of Dermatology (AAD). Moles. Patient Information. Schaumburg, IL: AAD; 1987.