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CPT 17000&17003 vs 17000x11

  1. Smile CPT 17000&17003 vs 17000x11
    Medical Coding Books
    There seems to be some kind of confusion with the word (each) found after code 17003...patient had 11 lesions destroyed, one coder coded as 17000 and 17003, another coder said that was wrong and it should have been coded as 17000x10. I would agree with the 17000 & 17003 for the total of 11 lesions. Coding it the other way would inflate the amt. of money charged by the facility greatly and therefore would be incorrect on my thinging. Can you assist or have any example cases addressing this case.

  2. #2
    Columbia, MO
    For 11 lesions .. the 17000 states first lesion, the 17003 states 2-14 EACH then it tells you to list separately. Therefor (and I knoe a lot of people use units but truely that is not correct) to show that you destroyed 11 lesions you will need 11 line items.
    17003 59
    17003 59
    and so on for 11 line items total.
    As I said some will use units but I have tested this many times and the reimbursement is more correct when you list it each time as instructed by the book. To use the 17000 and the 17003 x 10 indicates 2 lesions destroyed but one had to be done 10 times. To use the 17000 and only one 17003 indicates a total of 2 destroyed. It does not inflate the AR to do this correctly.

    Debra A. Mitchell, MSPH, CPC-H

  3. Default
    I do not agree with the posting of 17003 as different line items. I worked derm for many years and we always coded 17000 and 17003 x?. We never had a problem with incorrect reimbursement. That is the whole point of having a units box available on the form....

  4. #4
    Columbia, MO
    The units box is for codes that come as quantity distribution codes, such as time codes or drug codes. Surgical services do not come as quantities the are each one unique and distinct. Many payers will pay when you use units however I have found that by listing them as each line item the reimbursement is much better. Recently one of my students did switch from billing units to the line item using the 59 for this exact scenario, every payer she has billed this way has increased the reimbursement over what she recieved when billing units.. As I said I have tested this many times. I know many do use units but the book states each and says to list separately.

    Debra A. Mitchell, MSPH, CPC-H

  5. Default Ivis M. Fernandez
    I teach skin, and I think, by the books you must code 17000,17003*10

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