CPT code 17110 is for the destruction of 1 to 14 benign lesions using any method, such as laser or cryotherapy.
CPT code 17110 is used to describe the procedure for the destruction of benign lesions, such as warts or moles, on the skin. This code specifically applies when the healthcare provider treats between 1 to 14 lesions during a single session. The destruction can be achieved through various methods, including laser surgery, cryosurgery (freezing), or electrosurgery (burning). This code ensures that the provider is accurately reimbursed for the time and resources spent on treating these skin lesions.
When using CPT code 17110 for the destruction of benign lesions (1-14), several modifiers may be applicable depending on the specific circumstances of the procedure. Here is a list of potential modifiers and the reasons for their use:
1. Modifier 25: Significant, separately identifiable evaluation and management (E/M) service by the same physician on the same day of the procedure. Use this modifier if an E/M service was provided in addition to the lesion destruction.
2. Modifier 50: Bilateral procedure. Use this modifier if the procedure was performed on both sides of the body.
3. Modifier 51: Multiple procedures. Use this modifier if multiple procedures were performed during the same session.
4. Modifier 59: Distinct procedural service. Use this modifier to indicate that the procedure was distinct or independent from other services performed on the same day.
5. Modifier 76: Repeat procedure or service by the same physician. Use this modifier if the same procedure was repeated on the same day by the same physician.
6. Modifier 77: Repeat procedure by another physician. Use this modifier if the same procedure was repeated on the same day by a different physician.
7. Modifier 78: Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period. Use this modifier if the patient had to return for a related procedure.
8. Modifier 79: Unrelated procedure or service by the same physician during the postoperative period. Use this modifier if an unrelated procedure was performed during the postoperative period of the initial procedure.
9. Modifier LT: Left side. Use this modifier if the procedure was performed on the left side of the body.
10. Modifier RT: Right side. Use this modifier if the procedure was performed on the right side of the body.
11. Modifier GA: Waiver of liability statement issued as required by payer policy, individual case. Use this modifier if an Advance Beneficiary Notice (ABN) was issued to the patient.
12. Modifier GX: Notice of liability issued, voluntary under payer policy. Use this modifier if a voluntary ABN was issued.
13. Modifier GY: Item or service statutorily excluded, does not meet the definition of any Medicare benefit. Use this modifier if the service is not covered by Medicare.
14. Modifier GZ: Item or service expected to be denied as not reasonable and necessary. Use this modifier if no ABN was issued and the service is expected to be denied.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement.
CPT code 17110 is reimbursed by Medicare, but the reimbursement specifics can vary based on several factors. The Medicare Physician Fee Schedule (MPFS) provides the payment rates for services covered by Medicare, including CPT code 17110. To determine the exact reimbursement amount, healthcare providers should refer to the MPFS, which is updated annually.
Additionally, Medicare Administrative Contractors (MACs) play a crucial role in the reimbursement process. MACs are responsible for processing Medicare claims and can provide region-specific guidance on coverage and payment rates for CPT code 17110. Providers should consult their local MAC for detailed information on reimbursement policies and any potential variations in payment.
Discover how MD Clarity's RevFind software can meticulously analyze your contracts and pinpoint underpayments down to the CPT code level, including specific codes like 17110. Schedule a demo today to see how RevFind can help you ensure accurate reimbursements from every payer.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
