CPT code 17270 is for the destruction of skin lesions, typically through methods like freezing, burning, or other techniques.
CPT code 17270 is used to describe the medical procedure for the destruction of skin lesions. This code specifically refers to the treatment of benign (non-cancerous) skin growths or lesions using methods such as laser surgery, cryosurgery (freezing), electrosurgery (using electric currents), or other techniques. The goal of this procedure is to remove or destroy the unwanted skin lesions to improve the patient's skin health and appearance.
When billing for CPT code 17270, which pertains to the destruction of skin lesions, the following modifiers may be applicable:
1. Modifier 25: Significant, separately identifiable evaluation and management (E/M) service by the same physician 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 was above and beyond the usual preoperative and postoperative care associated with the procedure.
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 health care 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 health care 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 following initial procedure for a related procedure during the postoperative period. Use this modifier if the patient had to return to the operating room for a related procedure during the postoperative period.
8. Modifier 79: Unrelated procedure or service by the same physician during the postoperative period. Use this modifier if the procedure was unrelated to the original procedure and was performed during the postoperative period of the initial procedure.
9. Modifier LT: Left side. Use this modifier to indicate that the procedure was performed on the left side of the body.
10. Modifier RT: Right side. Use this modifier to indicate that 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 when a voluntary ABN was issued for services that are not covered.
13. Modifier GY: Item or service statutorily excluded or does not meet the definition of any Medicare benefit. Use this modifier when 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 when an ABN was not issued, and the service is expected to be denied.
These modifiers help provide additional information about the circumstances under which the procedure was performed and ensure accurate billing and reimbursement.
The CPT code 17270 is reimbursed by Medicare, but the reimbursement is subject to specific guidelines and conditions outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare, along with the corresponding reimbursement rates. Additionally, Medicare Administrative Contractors (MACs) play a crucial role in determining the local coverage and payment policies for this CPT code. It is essential for healthcare providers to consult both the MPFS and their respective MACs to ensure compliance with Medicare's billing and reimbursement requirements for CPT code 17270.
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