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+17003 2nd-14 lesion

  1. #1
    Question +17003 2nd-14 lesion
    Exam Training Packages
    HI,

    New to this, provider performed destruction of 5 actinic keratoses, 1st 17000, are the other 4 billed +17003 (1 unit) or 17003 (3 times)????? Not sure if 2nd through 14 lesions by description encompasses upt o 14 lesions or by stating the word "each", are they billable individually?

    Thanks
    Marilyn CPC, CPC-H, CEMC

  2. #2
    Location
    Columbia, MO
    Posts
    12,571
    Default
    The code states 2nd through 14 each and then it says list separately. I never bill with units and in fact have experienced others receiving rejections for units out range when they did. Each lesion destroyed was a unique and separate location so each one deserves separate consideration for payment. Therefoe I list each one on a separate line item. I do use the 59 modifier for the 2nd and subsequent 17003 so they do not edit out as a duplicate. you do not use a 51 as these are add on codes. I have always been rewarded with prompt and optimal payment when the dx code was correct.

    Debra A. Mitchell, MSPH, CPC-H

  3. Default
    I would bill

    17000 x 1
    17003 x 4

    Have been coding Derm for 23years and never had a problem

    Christine Liles
    Knoxville Dermatology Group PC

  4. #4
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    I agree with Christine and code just as she states. We have not had issue with units on 17003 either.
    Lisa Bledsoe, CPC, CPMA

  5. #5
    Location
    Columbia, MO
    Posts
    12,571
    Default
    I know that a lot of people do use units, however I have always received better reimbursement with line item. The CMS 1500 billing manual does state that units need be 1 unless the code is a quantity distribution item like timed services. I know that this is not a popular notion but I have doen the side by side compaison so to speak and the result was higher reimbursement when listed separately. Also this is the way the code states it is to be done. It says to list separately. Like I said I know it is not popular but you should remain open to the possibility that it just might be that listing each item separately will be better. I proved it to myself.

    Debra A. Mitchell, MSPH, CPC-H

  6. #6
    Smile
    Thank you very much....
    Marilyn CPC, CPC-H, CEMC

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