CPT code 17111 is for the destruction of 15 or more skin lesions using various methods such as laser, electrosurgery, or cryotherapy.
CPT code 17111 is used to describe the procedure for the destruction of 15 or more benign lesions. This code is typically utilized when a healthcare provider removes multiple non-cancerous growths, such as warts or skin tags, using methods like laser surgery, cryotherapy, or chemical treatment. The code ensures that the provider is accurately reimbursed for the time and resources required to treat a large number of lesions in a single session.
When using CPT code 17111 for the destruction of 15 or more lesions, 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 healthcare professional on the same day of the procedure or other service. Use this modifier if an E/M service was provided in addition to the lesion destruction.
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 may be necessary if multiple procedures are performed that are not typically reported together.
3. Modifier 76: Repeat procedure or service by the same physician or other qualified healthcare 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 healthcare professional. This modifier is used when the same 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 healthcare 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 healthcare professional during the postoperative period. Use this modifier if an unrelated procedure is performed during the postoperative period of the initial procedure.
7. Modifier LT: Left side. This modifier is used to specify that the procedure was performed on the left side of the body.
8. Modifier RT: Right side. This modifier is used to specify that the procedure was performed on the right side of the body.
9. Modifier XS: Separate structure. This modifier is used to indicate that a service was performed on a separate organ/structure.
10. Modifier XE: Separate encounter. This modifier is used to indicate that a service was performed during a separate encounter.
11. Modifier XP: Separate practitioner. This modifier is used to indicate that a service was performed by a different practitioner.
12. Modifier XU: Unusual non-overlapping service. This modifier is used to indicate that a service does not overlap usual components of the main service.
These modifiers help provide additional information about the procedure and ensure accurate billing and reimbursement. Always refer to the latest coding guidelines and payer-specific requirements when applying modifiers.
The CPT code 17111, which involves the destruction of lesions, is reimbursed by Medicare. To determine the specific reimbursement rate, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS). The MPFS provides detailed information on the payment rates for various CPT codes, including 17111. Additionally, reimbursement can vary slightly depending on the region, as Medicare Administrative Contractors (MACs) may have localized adjustments. Therefore, it is advisable to consult the relevant MAC for precise reimbursement details in your specific area.
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