CPT CODES

CPT Code 17282

CPT code 17282 is for the destruction of skin lesions, a procedure to remove abnormal skin growths using various techniques.

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What is CPT Code 17282

CPT code 17282 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, through methods like laser surgery, cryotherapy (freezing), or electrosurgery (using electric currents). The goal of this procedure is to remove or destroy the unwanted skin tissue to prevent further growth or potential malignancy.

Does CPT 17282 Need a Modifier?

When billing for CPT code 17282, 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 during the postoperative period.

8. Modifier 79: Unrelated procedure or service by the same physician during the postoperative period. Use this modifier if an unrelated procedure 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 for a service that might not be covered by Medicare.

12. Modifier GX: Notice of liability issued, voluntary under payer policy. Use this modifier when 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, does not meet the definition of any Medicare benefit. Use this modifier for services that are 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 by Medicare.

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

CPT Code 17282 Medicare Reimbursement

The CPT code 17282 is reimbursed by Medicare, but the reimbursement is subject to specific guidelines and conditions outlined in the Medicare Physician Fee Schedule (MPFS). To determine the exact reimbursement rate and any additional requirements, healthcare providers should consult the MPFS.

Additionally, it is important to verify with the local Medicare Administrative Contractor (MAC) for any region-specific policies or coverage determinations that may affect reimbursement for CPT code 17282.

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