CPT CODES

CPT Code 17250

CPT code 17250 is used for the chemical cauterization of granulation tissue, a procedure to remove excess tissue that forms during healing.

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What is CPT Code 17250

CPT code 17250 is used for the chemical cauterization of granulation tissue. This procedure involves applying a chemical agent to abnormal tissue growth, often found in wounds or ulcers, to remove or reduce the tissue. The goal is to promote healing and prevent further complications. This code is typically used by healthcare providers to document and bill for this specific treatment.

Does CPT 17250 Need a Modifier?

When using CPT code 17250 for chemical cauterization of granulation tissue, 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 on the same day as the procedure and is distinct from the procedure itself.

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 or other qualified healthcare professional. Use this modifier if the procedure was repeated on the same day by the same provider.

6. Modifier 77: Repeat procedure by another physician or other qualified healthcare professional. Use this modifier if the procedure was repeated on the same day by a different provider.

7. 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. Use this modifier if the patient had to return for a related procedure during the postoperative period.

8. Modifier 79: Unrelated procedure or service by the same physician or other qualified healthcare professional during the postoperative period. Use this modifier if the procedure was unrelated to the original procedure and occurred during the postoperative period.

9. Modifier 91: Repeat clinical diagnostic laboratory test. Use this modifier if the procedure involves a repeat clinical diagnostic laboratory test.

10. Modifier LT: Left side. Use this modifier if the procedure was performed on the left side of the body.

11. Modifier RT: Right side. Use this modifier if the procedure was performed on the right side of the body.

These modifiers help provide additional information about the procedure and ensure accurate billing and reimbursement. Always verify payer-specific guidelines as they may have unique requirements for modifier usage.

CPT Code 17250 Medicare Reimbursement

The CPT code 17250 is reimbursed by Medicare, but its reimbursement is subject to specific guidelines and conditions outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides the payment rates for services and procedures covered by Medicare, including CPT code 17250. Additionally, Medicare Administrative Contractors (MACs) play a crucial role in determining the local coverage and reimbursement policies for this code. Providers should consult their respective MACs to understand any regional variations or additional documentation requirements that may apply to ensure proper reimbursement for CPT code 17250.

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