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Need units for 17003?

  1. #1
    Location
    Salt Lake North
    Posts
    691
    Cool Need units for 17003?
    Medical Coding Books
    So if a patient has 6 lesions removed

    17000 first lesion
    17003 2nd - 6th

    or

    17000 first lesion
    17003 X5 2nd -6th

    Thank you for your help.

  2. #2
    Location
    Evansville Indiana
    Posts
    451
    Default 17003
    17003 is billed as each so

    17000 first lesion
    17003 X5 2nd -6th
    is correct

  3. #3
    Location
    Columbia, MO
    Posts
    12,841
    Default
    Truely if you read the CPT book you do not bill units, it states to "list separately"
    I have always billed
    17000
    17003
    17003 59
    17003 59
    17003 59
    17003 59
    I have compared reimbursements many times and this on the whole seems to pay better. I have instructed ohters to bill this way and all have told me their reimbursement went up more times than not.

    Debra A. Mitchell, MSPH, CPC-H

  4. #4
    Default
    I'd agree. We itemizel it out, instead of using units on the 17003 also.

  5. Default
    17003 Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); second through 14 lesions, each (List separately in addition to code for first lesion)

    Coding 17000 and 17003 x5 is correct. There is no rational for 17000 + 17003 + 17003 to pay more than 17000 + 17003x2. If you are getting paid more for listing separately it's just because the -59 is bypassing that payer's system payment methodology. It's not money that you are due.

  6. #6
    Location
    Columbia, MO
    Posts
    12,841
    Default
    It is correct to list EACH as that is what the code states. This is not a quantity distributed service. Units are for quntity distrubuted codes (it states this in the manual), when you put 5 units it signifies the same lesion 5 times. This is incorrect. You destructed 5 independent lesions so you list them separately and that is why the reimbursement is higher. It is money you are due.

    Debra A. Mitchell, MSPH, CPC-H

  7. Default
    Well I never knew. Thanks

  8. #8
    Location
    Evansville Indiana
    Posts
    451
    Default 17003
    I do agree with you Debra. I should have been more complete with my answer, I was directing it more towards the fact that 17003 is for each rather than whether to use units or 59 modifiers. In my experience some of the payers want it with 59 and some will only take it as units.

  9. Default
    The -59 is incorrect, you should only bill with units (up to 13), you are setting yourself up for an audit and are most likely bypassing payers edits by appending -59, which CAN affect reimbursement. Your rationale about quantity billing does not apply just by virtue of the code nomenclature .... IMHO, from a payer's perspective ...
    Sharon D., MA

  10. #10
    Location
    Columbia, MO
    Posts
    12,841
    Default
    Please explain what you mean "by virtue of the codes nomenclature". Billing with units is not correct as surgical procedures do come as quantity distributions. The code states each and each is not a quantity. every 15 minutes is a quantity so 30 minutes is 2 units.

    Debra A. Mitchell, MSPH, CPC-H

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