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Wiki 96920-96922

annmarieO

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does anyone know if the (psoriasis) indicated in the descriptions of these codes means that the code is used to report laser treatment for psoriasis only or can it be reported for laser treatment of other inflammatory skin diseases such as atopic dermatitis?

Typically, descriptions in the CPT manual which have ( ) have a e.g., but this one does not:(
 
No, but...

Annmarie,

My understanding is that some do consider this code to include laser tx of eczema, atopic derm, etc, but it is unlikely to be covered by insurance for any condition other than psoriasis (meaning those on the insurance side read the description exactly and without open interpretation.) Compared to phototherapy for atopic derm, laser treatments are in their infancy and I think it will take many years (not to mention many controlled studies with positive outcomes) before we get coverage for ad, eczema, etc. (if it comes at all.) It's still worth a call to the patient's carrier to see what they say about it. Sometimes insurance companies can pleasantly surprise my patients. If this equipment were to come into my office, our approach would be on a case by case (read: attempt at preapproval) basis. As a phototherapist I read the code to include my atopic patients and I would advocate for insurance coverage. As a coder, though, my opinion is "no." Sometimes it's very difficult walking this tightrope.

Best,

Katie Hanninen, CPC, CPCD
Phototherapist
 
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