CPT code 17274 is used for the medical procedure involving the destruction of skin lesions, typically through methods like laser or cryotherapy.
CPT code 17274 is used to describe the medical procedure for the destruction of skin lesions. This code specifically refers to the treatment of skin growths or abnormalities, such as warts, moles, or other lesions, using methods like laser surgery, cryosurgery (freezing), or electrosurgery (burning). The goal of this procedure is to remove or destroy the unwanted skin tissue for medical or cosmetic reasons.
When billing for CPT code 17274, 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 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 for a related procedure.
8. 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.
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 for a service that may not be covered by Medicare.
12. Modifier GX: Notice of liability issued, voluntary under payer policy. Use this modifier if a voluntary ABN was issued for a service that is statutorily excluded or does not meet the definition of any Medicare benefit.
13. Modifier GY: Item or service statutorily excluded or 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.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
The CPT code 17274 is reimbursed by Medicare, but the reimbursement amount can vary based on several factors. The Medicare Physician Fee Schedule (MPFS) provides the payment rates for services covered by Medicare, including CPT code 17274. However, the final reimbursement is often determined by the Medicare Administrative Contractor (MAC) for your specific region. Each MAC may have slightly different policies and rates, so it's essential to consult the local MAC guidelines to understand the exact reimbursement details for CPT code 17274.
Discover how MD Clarity's RevFind software can meticulously read your contracts and detect underpayments down to the CPT code level and by individual payer. Ensure you're receiving full reimbursement for procedures like CPT code 17274. Schedule a demo today to see how RevFind can optimize your revenue cycle management.
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
