CPT code 17273 is for the destruction of skin lesions, involving the removal of abnormal skin growths through various methods.
CPT code 17273 is used for the destruction of skin lesions, specifically for those that are malignant (cancerous). This code covers procedures where a healthcare provider uses methods such as laser surgery, cryosurgery (freezing), electrosurgery (electric current), or other techniques to remove cancerous skin growths. The goal of this procedure is to eliminate the malignant tissue to prevent the spread of cancer and promote healthy skin regeneration.
When billing for CPT code 17273, 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 in addition to the procedure.
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.
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.
4. Modifier 77: Repeat procedure by another physician or other qualified health care 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 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.
6. Modifier 79: Unrelated procedure or service by the same physician during the postoperative period. Use this modifier if the procedure is unrelated to the original procedure performed.
7. Modifier 58: Staged or related procedure or service by the same physician during the postoperative period. This modifier is used if the procedure was planned or anticipated at the time of the original procedure.
8. Modifier LT: Left side. This modifier is used to indicate that the procedure was performed on the left side of the body.
9. Modifier RT: Right side. This modifier is used to indicate that the procedure was performed on the right side of the body.
10. Modifier 50: Bilateral procedure. Use this modifier if the procedure was performed on both sides of the body.
11. Modifier 51: Multiple procedures. This modifier is used when multiple procedures are performed during the same session.
12. Modifier 22: Increased procedural services. This modifier is used if the work required to perform the procedure is substantially greater than typically required.
13. Modifier 24: Unrelated evaluation and management service by the same physician during a postoperative period. Use this modifier if an E/M service is provided that is unrelated to the original procedure.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement.
When determining if CPT code 17273 is reimbursed by Medicare, it is essential to consult the Medicare Physician Fee Schedule (MPFS) and the guidelines provided by your regional Medicare Administrative Contractor (MAC). The MPFS is a comprehensive listing of the maximum fees Medicare will pay for various services, and it is updated annually.
To verify reimbursement for CPT code 17273, you should:
1. Check the MPFS: Access the latest version of the MPFS to see if CPT code 17273 is listed and to review the associated reimbursement rates.
2. Consult Your MAC: Each MAC may have specific guidelines or additional requirements for reimbursement. It is crucial to review any local coverage determinations (LCDs) or national coverage determinations (NCDs) that pertain to CPT code 17273.
By following these steps, you can determine if CPT code 17273 is reimbursed by Medicare and understand any specific conditions or documentation requirements that may apply.
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