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Coding Multiple Lesions

  1. #1
    Wink Coding Multiple Lesions
    Medical Coding Books
    Hello i have a basic coding question.... I am rusty with Lesions... Can some one tell me when coding 3 lesions after the initial code of 17000 and then the add on code for 17003 (2-14 lesions) in the units do I change the units? So for ex: I have 3 lesions, I use the intial code and then the add on code for the 2nd... Do I need to change the units to show I have 2 lessions in this add on code or leave it alone and let it stand as is? Txs for your help!

  2. #2
    Smile lesions
    For 3 units you would use:
    17000 1 unit
    17003 1 unit

    this covers it all up to 14 lesions then if 15 or more you would use
    17004 alone. Hope that helps!

  3. #3
    Default
    txs sooooo much it sure does!!!

  4. Default
    Because the description on 17003 says second through 14th lesions "each", I would code 17000 and then 17003 with 2 units for 3 lesions.

  5. #5
    Location
    Albany, New York
    Posts
    456
    Smile
    Please refer below to an excerpt from a CPT Assistant:

    Code 17000 was revised to expand its application. The revisions include the deletion of the reference to "facial lesions" allowing these codes to be reported for the destruction of any benign or premalignant lesions.

    Skin tag destruction is now coded with codes 11200 and 11201. The language following the semicolon was revised by replacing the word "one" with "first." This revision clarifies that code 17000 should only be reported one time for the first lesion and never multiple times.

    (17001, 17002 have been deleted. To report, see 17003, 17004)

    Codes 17001 and 17002 have been deleted since the destruction of the second, third, and all lesions through 14 are now reported with the new code 17003. A parenthetical statement was added cross referencing deleted codes 17001 and 17002 to new codes 17003 and 17004.

    17003 second through 14 lesions, each (List separately in addition to code for first lesion)

    (Use 17003 only in addition to 17000)

    Code 17003 was added to report the destruction of lesions 2 through 14. Each lesion should be reported separately using the units box, as the code descriptor states "each." As stated in the parenthetical statement following the code descriptor, code 17003 should be reported separately in addition to the code for the first lesion. This is further clarified in a second parenthetical statement following code 17003 that states use code 17003 only in addition to code 17000.
    17004 15 or more lesions

    Code 17004 was added as a stand alone code to describe the destruction of 15 or more lesions. It is not appropriate to report code 17004 in addition to codes 17000 and 17003 as code 17004 was added as a stand alone code and is reported by itself for the destruction of 15 or more lesions. For example, if 17 lesions are destroyed, only code 17004 would be reported.

    (17010 has been deleted. To report, see specific anatomic site code)

    Code 17010 was deleted because it was not clear what constituted complicated lesions. A cross reference was added to direct users to site specific destruction codes for locations of lesions in more sensitive sites.

    (17100-17105 have been deleted. To report, see 17000, 17003, 17004)

    A parenthetical statement was added cross referencing deleted codes 17100-17105 with codes 17000, 17003 and 17004 that are now used to report the destruction of, benign or premalignant lesions, other than skin tags and cutaneous vascular proliferative lesions, in any location.

    % 17110* Destruction by any method of flat warts, molluscum contagiosum, or milia; up to 14 lesions

    17111 15 or more lesions

    (For destruction of common or plantar warts, see 17000, 17003, 17004 )

    Code 17110 has been revised and code 17111 was added to provide consistency with the other destruction of lesions codes in CPT. Code 17110 is now reported for destruction of up to 14 lesions and new code 17111 is reported for destruction of 15 or more lesions. It is not appropriate to report codes 17110 and 17111 together. For example, if 20 flat warts are destroyed, only code 17111 should be reported, as it includes destruction of 15 lesions or more than 15 lesions.

    The parenthetical statement that previously followed code 17110 stating "Retreatment same as office visit" was deleted as retreatment of flat warts should now be reported with code 17110 or 17111, not as an office visit.

    As a result of the revisions to the destruction series of codes, the parenthetical statement that previously followed code 17110 was revised to direct users to the new destruction codes 17000, 17003 and 17004 that are used to report the destruction of common or plantar warts.

    (17200, 17201 have been deleted. To report, see 11200, 11201)

    As the skin tag removal codes 11200 and 11201 have been revised to include destruction, codes 17200 and 17201 have been deleted. As a result of the revision of codes 11200 and 11201, the parenthetical statement directing users to codes 11200 and 11201 that followed code 17201 was deleted. A new cross reference was added to direct users to codes 11200 and 11201 for deleted codes 17200 and 17201.

    17250* Chemical cauterization of granulation tissue (proud flesh, sinus or fistula)

    (17250 is not to be used with removal or excision codes for the same lesion)

    Cross reference for code 17250 was revised to clarify that chemical cauterization should not be used with removal or excision codes for the same lesion. If 17250 is performed on a separate lesion, 17250 may be reported with the -59 modifier.

    % 19120 Excision of cyst, fibroadenoma, or other benign or malignant tumor aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19140), male or female, one or more lesions

    An editorial revision was made to code 19120 to include the areolar area.

    CPT Assistant © Copyright 1990–2009 American Medical Association. All Rights Reserved

    Based on this information, I would use 17000 (1 unit)
    17003 (2 units)
    Karen Maloney, CPC
    Data Quality Specialist

  6. #6
    Location
    Columbia, MO
    Posts
    12,531
    Default
    I agree somewhat except I do not use units
    17000
    17003
    17003 59
    This indicates 3 separate lesions. I know many do use units but if you really look at the instructions in the billing manual it says to use units for services that come as quantities such as timed services, each is not a quantity it is each one unique and distinct therefore I use the 59.

    Debra A. Mitchell, MSPH, CPC-H

  7. #7
    Smile
    Txs soooo much everyone for all your help I really appreciate it!!!!

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