CPT code 17286 is used for the medical procedure involving the destruction of skin lesions.
CPT code 17286 is used to describe the medical procedure for the destruction of skin lesions. This code specifically refers to the treatment of malignant skin lesions using methods such as laser surgery, electrosurgery, cryosurgery, or chemosurgery. The goal of this procedure is to remove or destroy abnormal skin growths that could potentially be harmful. This code is essential for accurate billing and ensures that healthcare providers are reimbursed for the specific services they provide in treating skin lesions.
When billing for CPT code 17286, 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.
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 was unrelated to the original procedure performed.
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 may not be covered.
12. Modifier GC: This service has been performed in part by a resident under the direction of a teaching physician. Use this modifier if the procedure involved a resident under the supervision of a teaching physician.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
When considering whether CPT code 17286 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 is a comprehensive listing of the payment rates used by Medicare to reimburse physicians and other healthcare providers for services rendered. Each MAC, which administers Medicare claims for specific regions, may have additional guidelines or local coverage determinations (LCDs) that affect reimbursement.
For CPT code 17286, you would first check the MPFS to see if the code is listed and what the reimbursement rate is. Additionally, reviewing the LCDs and any relevant articles published by your MAC will provide further clarity on whether this specific code is reimbursed and under what conditions. Always ensure that the service meets the medical necessity criteria outlined by Medicare to secure reimbursement.
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