CPT code 17284 is for the destruction of skin lesions, a procedure used to remove abnormal skin growths through various methods.
CPT code 17284 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, cryotherapy (freezing), or electrosurgery (burning). The goal of this procedure is to remove or destroy the unwanted skin tissue to improve the patient's skin health and appearance.
When using CPT code 17284 for the destruction of skin lesions, several modifiers may be applicable depending on the specific circumstances of the procedure. Below is a list of potential modifiers and the reasons for their use:
1. Modifier 25 - Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service
- Use this modifier if a significant, separately identifiable evaluation and management (E/M) service is performed by the same physician on the same day as the procedure.
2. Modifier 50 - Bilateral Procedure
- Apply this modifier if the procedure is performed on both sides of the body.
3. Modifier 51 - Multiple Procedures
- Use this modifier when multiple procedures are performed during the same session.
4. 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.
5. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional
- Use this modifier if the same procedure is repeated by the same physician on the same day.
6. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional
- Apply this modifier if the same procedure is 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 returns to the operating room for a related procedure during the postoperative period.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- Apply this modifier if an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
9. Modifier LT - Left Side (Used to identify procedures performed on the left side of the body)
- Use this modifier to specify that the procedure was performed on the left side of the body.
10. Modifier RT - Right Side (Used to identify procedures performed on the right side of the body)
- Apply this modifier to specify 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 when a waiver of liability statement is issued as required by payer policy.
12. Modifier GX - Notice of Liability Issued, Voluntary Under Payer Policy
- Apply this modifier when a notice of liability is issued voluntarily under payer policy.
13. Modifier GY - Item or Service Statutorily Excluded, Does Not Meet the Definition of Any Medicare Benefit
- Use this modifier when the item or service is statutorily excluded or does not meet the definition of any Medicare benefit.
14. Modifier GZ - Item or Service Expected to Be Denied as Not Reasonable and Necessary
- Apply this modifier when the item or service is expected to be denied as not reasonable and necessary.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
When determining if CPT code 17284 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 provides a comprehensive list of services covered by Medicare, along with the corresponding reimbursement rates. Additionally, MACs, which are private health care insurers that have jurisdiction in specific regions, offer further guidance and clarification on coverage policies.
For CPT code 17284, you would need to verify its inclusion in the MPFS and review any local coverage determinations (LCDs) or national coverage determinations (NCDs) issued by your MAC. These resources will confirm whether Medicare reimburses this specific code and under what conditions. Always ensure to stay updated with the latest guidelines from both the MPFS and your MAC to ensure accurate billing and reimbursement.
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