Wiki 17000 or 17110?

[ivygirl18@hotmail.com]

Hi,

I have a provider who had completed cryosurgery on a lesion on nose. He had dx it with D49.2 Neoplasm of unspecified behavior of hone, soft tissue, and skin. He had sent them to derm or plastic surgery. I feel based on his documentation 17110 is correct, however, the provider thinks it is 17000 based on the path report stating it is a Acticinic Keratosis from the plastic surgeon had done over 2 weeks after my provider had done the cryosurgery. Can you or should you base the procedure code on what was done weeks after by another provider? I know when you do excisions you wait for the path report to come back to determine how to code it.

 

[zoinks071]

I would say if you have a confirmed path stating that the lesion was definitively an AK then it would be most appropriate to use 17000. If you had no other documentation to refer to I would agree with the D49.2 and 17110 as it would default to the benign CPT in the absence of any other definitive diagnosis. My question would be if your provider performed a true destruction then how was the plastic surgeon able to have any tissue left for a pathology two weeks later? I suppose there could have been residual AK left over, but it just sounds a bit confusing (in my opinion).

I hope that helps

 

[crawfordmom4]

I would say if you have a confirmed path stating that the lesion was definitively an AK then it would be most appropriate to use 17000. If you had no other documentation to refer to I would agree with the D49.2 and 17110 as it would default to the benign CPT in the absence of any other definitive diagnosis. My question would be if your provider performed a true destruction then how was the plastic surgeon able to have any tissue left for a pathology two weeks later? I suppose there could have been residual AK left over, but it just sounds a bit confusing (in my opinion).

I hope that helps

I agree! If you do not have path or if the provider is stating it in an unknown neoplasm then you must bill 17110 with D49.2 (we use D48.5) if destroying and not sending to path. It's on the provider for documentation.

 

[slantzer]

We had same problem with unspecified codes , we use D48.5. Any unspecified codes would not be paid, we had to change dx codes to specified descriptions or "other" instead of unspecified.