CPT CODES

CPT Code 17283

CPT code 17283 is a medical code used to describe the procedure for the destruction of skin lesions.

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What is CPT Code 17283

CPT code 17283 is used to describe the medical procedure for the destruction of skin lesions. This code specifically refers to the treatment of malignant skin lesions, such as skin cancer, through methods like laser surgery, electrosurgery, cryosurgery, or chemosurgery. The goal of this procedure is to remove or destroy the abnormal tissue to prevent the spread of the disease and promote healing.

Does CPT 17283 Need a Modifier?

For CPT code 17283, 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 by the same physician on the same day.

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

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 procedure performed during the postoperative period of another surgery.

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

10. Modifier RT: Right side. Use this modifier if the destruction of skin lesions 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 the destruction of skin lesions.

12. Modifier GX: Notice of liability issued, voluntary under payer policy. Use this modifier if a voluntary ABN was issued for the destruction of skin lesions.

13. Modifier GY: Item or service statutorily excluded or does not meet the definition of any Medicare benefit. Use this modifier if the destruction of skin lesions is not covered by Medicare.

14. Modifier GZ: Item or service expected to be denied as not reasonable and necessary. Use this modifier if the destruction of skin lesions is expected to be denied by Medicare as not medically necessary.

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 17283 Medicare Reimbursement

The CPT code 17283 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 the payment rates for services covered under Medicare Part B, and it is essential to consult this schedule to determine the exact reimbursement rate for CPT code 17283.

Additionally, Medicare Administrative Contractors (MACs) play a crucial role in the reimbursement process. MACs are responsible for processing Medicare claims and ensuring that services meet Medicare coverage criteria. They may have local coverage determinations (LCDs) that provide further guidance on the reimbursement of CPT code 17283. Therefore, it is advisable to review both the MPFS and any relevant LCDs from your specific MAC to ensure compliance and accurate reimbursement for this code.

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