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17000 Destruction First Lesion, 17003 Each Additional

  1. Default 17000 Destruction First Lesion, 17003 Each Additional
    Medical Coding Books
    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?

  2. Default
    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!

    _____________________
    April Sue

  3. #3
    Default
    17000 and 17003 get the 59 modifier.

  4. #4
    Smile 17000 and 17003
    I agree with Catch The Wind

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

  6. #6
    Default
    That has begun to change. Some payers now want the modifier on the add-on codes, as well.

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

  8. #8
    Location
    St Paul, MN
    Posts
    17
    Default
    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...

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