CPT CODES

CPT Code 17280

CPT code 17280 is a medical code used to describe the procedure for the destruction of skin lesions.

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What is CPT Code 17280

CPT code 17280 is used to describe the medical procedure for the destruction of skin lesions. This code is specifically applied when a healthcare provider removes skin lesions using methods such as laser surgery, electrosurgery, cryosurgery, or chemical treatment. The goal of this procedure is to eliminate abnormal skin growths, which could be benign, pre-malignant, or malignant, to prevent further complications or to improve the patient's skin health.

Does CPT 17280 Need a Modifier?

For CPT code 17280, 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 destruction of skin lesions.

2. Modifier 50: Bilateral procedure. Use this modifier if the destruction of skin lesions was performed on both sides of the body.

3. Modifier 51: Multiple procedures. Use this modifier if multiple procedures, including the destruction of skin lesions, were performed during the same session.

4. Modifier 59: Distinct procedural service. Use this modifier to indicate that the destruction of skin lesions was a distinct service from other procedures performed on the same day.

5. Modifier 76: Repeat procedure or service by the same physician. Use this modifier if the destruction of skin lesions was repeated on the same day by the same physician.

6. Modifier 77: Repeat procedure by another physician. Use this modifier if the destruction of skin lesions was repeated on the same day by a different physician.

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 additional destruction of skin lesions related to the initial procedure.

8. Modifier 79: Unrelated procedure or service by the same physician during the postoperative period. Use this modifier if the destruction of skin lesions was unrelated to a previous procedure performed during the postoperative period.

9. Modifier 91: Repeat clinical diagnostic laboratory test. Use this modifier if the destruction of skin lesions required repeat laboratory tests on the same day.

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

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

These modifiers help provide additional information about the circumstances under which the destruction of skin lesions was performed, ensuring accurate billing and reimbursement.

CPT Code 17280 Medicare Reimbursement

The CPT code 17280 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. Providers should consult their respective MACs to understand any regional variations or additional documentation requirements that may affect reimbursement for CPT code 17280.

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