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Billing 9 -Pre-malignant lesions It is timing ???

  1. Default Billing 9 -Pre-malignant lesions It is timing ???
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    My Question is Do I have to use UNITS in the CMS-1500 when I Bill 9 Pre-malignant lesion.

  2. #2
    Location
    Columbia, MO
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    what procedure did you perform, and how do you think it should be billed.

    Debra A. Mitchell, MSPH, CPC-H

  3. Default Sorry !
    I mean destruction of 9 premalignant lesion, do I have to Time or Not, and another question is In the CMS Do I have to use Units =9 ?

  4. #4
    Location
    Columbia, MO
    Posts
    12,558
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    These are not timed procedures you may be confused with the physician "time out" that he is now required to document prior to performing an office procedure. I do not use units when billing surgical procedure as these do not come in quantities. the 17000 is first lesion, 17003 is 2-14 each which is not a quantity, and it states to list separately. I have had several offices convert from billing units to the way I do it and each one has confirmed higher reimbursement my way so having said that I would do
    17000
    17003
    17003 59
    17003 59
    17003 59
    17003 59
    17003 59
    17003 59
    17003 59
    This wil require a 2 page claim.

    Debra A. Mitchell, MSPH, CPC-H

  5. Default
    No modifier 59 is needed with add-on codes

    17000
    17003 x 8

  6. Exclamation Coding/Billing Manager
    Debra's billing would be correct. Use 17000 and 17003 for each additonal lesion. Add-on 17003 list second through 14 lesions with notes to list separately. Since CMS and Cahaba made the reference to modifier 59, I have had to re-bill some add on codes with the modifier 59. It's been hard keeping up with who now requires 59 and who doesn't. If your carrier denies 17000 with 17003 do a corrected claim adding 59 to each 17003. You do not use units since the add-on is for second thru 14 lesion.
    Last edited by vlwinfrey; 05-17-2010 at 10:29 AM. Reason: Error

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