Wiki Need Help - Our doctor says he performed a laser photocoagulation

[nkorab]

Our doctor says he performed a laser photocoagulation of a lesion on the left leg about 1 cm in size.

says the DX is 739.6

We billed this DX with CPT 17000. Medicare denied as not deemed "medically necessary". This usually means the DX is wrong.

So what DX to use for lesion on left leg?
This was not a skin tag.

Or am I way off base? Your help is greatly appreciated.
Nancy K

 

[lseelinger]

lseelinger,CPC

Pull up your local LCD for 17000 and check the diagnosis codes listed in it. Hopefully there will be one listed. I'm on the East-coast so we use Novitas.
Go to Novitas-solutions.com and pick your jurisdiction and pick whether your Part B physician or Part A Hospital, then go to LCD policies put in the info required (ex- 17000) the policy will come up under Removal of Benign or Malignant Lesions.

 

[mitchellde]

Our doctor says he performed a laser photocoagulation of a lesion on the left leg about 1 cm in size.

says the DX is 739.6

We billed this DX with CPT 17000. Medicare denied as not deemed "medically necessary". This usually means the DX is wrong.

So what DX to use for lesion on left leg?
This was not a skin tag.

Or am I way off base? Your help is greatly appreciated.
Nancy K

To locate a skin lesion you look under key word lesion, then skin . This will direct you to 709.9. Which is the correct code for a skin lesion. However do be prepared for this to deny due to cosmetic. But it can be appealed. The 739.6 is a code for non allopathic lesions which is usually in the spine or musculoskeletal area. These are not skin lesions.

 

[oub0275]

Need Help

CPt code 17000 is for the destruction of pre-malignant lesions. I think you RE using the wrong procedure code for your diagnosis code.

 

[nkorab]

Thank you

Thank you guys so much. this one really had me going.
I now see we did use the wrong DX for our procedure code.

Love this forum.
Thanks again.

Nancy K