CPT code 17001 is used for the destruction of premalignant skin lesions, such as actinic keratoses, by any method, including cryotherapy.
CPT code 17001 is used to describe the procedure for the destruction of a premalignant lesion, such as actinic keratosis, using techniques like laser surgery, electrosurgery, cryosurgery, or chemical treatment. This code specifically applies to the first lesion treated. If additional lesions are treated during the same session, different codes would be used to account for those.
For CPT code 17001, the following modifiers may be applicable:
1. Modifier 25: Significant, separately identifiable evaluation and management (E/M) service by the same physician or other qualified health care professional on the same day of the procedure or other service. Use this modifier if an E/M service is provided on the same day as the procedure and is distinct from the procedure itself.
2. Modifier 59: Distinct procedural service. This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day. It is used to identify procedures/services that are not normally reported together but are appropriate under the circumstances.
3. Modifier 76: Repeat procedure or service by the same physician or other qualified health care professional. Use this modifier if the same procedure is repeated on the same day by the same provider.
4. Modifier 77: Repeat procedure by another physician or other qualified health care professional. This modifier is used when a procedure is repeated on the same day by a different provider.
5. Modifier 78: Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period. This modifier is used if the patient needs to return to the operating room for a related procedure during the postoperative period.
6. Modifier 79: Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period. Use this modifier if an unrelated procedure is performed by the same provider during the postoperative period of the initial procedure.
7. Modifier 91: Repeat clinical diagnostic laboratory test. This modifier is used to indicate that a laboratory test was repeated on the same day to obtain subsequent (multiple) test results.
8. Modifier LT: Left side (used to identify procedures performed on the left side of the body).
9. Modifier RT: Right side (used to identify procedures performed on the right side of the body).
10. Modifier XS: Separate structure. This modifier is used to indicate a service that is distinct because it was performed on a separate organ/structure.
11. Modifier XE: Separate encounter. This modifier is used to indicate a service that is distinct because it occurred during a separate encounter.
12. Modifier XP: Separate practitioner. This modifier is used to indicate a service that is distinct because it was performed by a different practitioner.
13. Modifier XU: Unusual non-overlapping service. This modifier is used to indicate a service that is distinct because it does not overlap usual components of the main service.
These modifiers help provide additional information about the performed procedure and ensure accurate billing and reimbursement. Always refer to the latest coding guidelines and payer-specific requirements when applying modifiers.
The CPT code 17001 is reimbursed by Medicare, but it is essential to verify the specific reimbursement details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and their corresponding reimbursement rates.
Additionally, it is advisable to consult with your local Medicare Administrative Contractor (MAC) to confirm any regional variations or specific guidelines that may affect the reimbursement process for CPT code 17001.
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