Wiki 17000 Destruction First Lesion, 17003 Each Additional

[C04162]

Cryotherapy was done to 3 sites- 2 with dx code of 702.0 actinic keratosis and one with dx code 702.11 inflamed seborrheic keratosis. MD coded 17000 x 2 and 17003 x 1. Can 17000 be coded x 2 in one session if the dx codes are different for the 2 sites. If these codes are correct, would a -59 modifier be added to one of the 17000 codes?

 

[AprilSueMadison]

An ISK is a benign skin lesion, while an AK is a pre-cancerous skin lesion. They have separate codes.

17000 702.0
17003 x 1 702.0
17110 702.11

You will need to review your NCCI edits/rules to determine if a 59 should be appended to this claim.

I hope this helps!

 

[CatchTheWind]

17000 and 17003 get the 59 modifier.

 

[denarh40]

17000 and 17003

I agree with Catch The Wind

 

[sarahandross@rocketmail.com]

A 59 modifier is not needed on the 17003. Just the 17000 =)

 

[CatchTheWind]

That has begun to change. Some payers now want the modifier on the add-on codes, as well.

 

[sarahandross@rocketmail.com]

Actually the 59 modifier is going away effective Jan 2015 =) Just got a big packet on my desk at work from Medicare.

 

[nkrush12]

CMS will continue to recognize the -59 modifier, but notes that Current Procedural Terminology (CPT) instructions state that the -59 modifier should not be used when a more descriptive modifier is available, such as the new modifiers of -XE, -XP, -XS or -XU

I would also check your local MAC, ours (NGS) is giving us conflicting information...