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17003 Excessive Units

  1. Question 17003 Excessive Units
    Medical Coding Books
    Our office has been contacted requesting an overpayment refund request (by Connolly on behalf of BCBSNC) stating that we billed 17000 and 17003 x 10 units. Their request states "Per CPT book 17003 covers lesions (2-14) and should be only billed with 1 unit"

    Is this not incorrect???

  2. #2
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    Quote Originally Posted by eeason View Post
    Our office has been contacted requesting an overpayment refund request (by Connolly on behalf of BCBSNC) stating that we billed 17000 and 17003 x 10 units. Their request states "Per CPT book 17003 covers lesions (2-14) and should be only billed with 1 unit"

    Is this not incorrect???
    You have to appeal this. Tell them to hire someone who can read CPT correctly
    CPT states: 17000 Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); first lesion
    +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)

    As you see 17003 is an add on code and it is billed separatelly for each additional lesions up to 14.

  3. #3
    Default
    It is correct that you cannot bill 17003 X10 units. This would mean the patient had hundreds of lesions destroyed. If there were 10 lesions than you would bill 17000 for the first lesion destroyed and 17003 for the rest up to 14. 17004 is billed alone for 15 or more lesions without the 17000 or 17003. Hope this helps!

  4. #4
    Location
    Terre Haute, Indiana
    Posts
    6
    Smile 17003 Excessive units
    You need to appeal this and they need to be able to read the CPT book because it specifically says, each and if you look at the net code it does not say each.

  5. #5
    Location
    Barren River Area
    Posts
    7
    Smile
    Appeal. I bill 17003 with multiple units all the time. Longs it is not more than 13 you are good to go.

  6. #6
    Location
    Dover Seacoast New Hampshire
    Posts
    1,970
    Default
    The word "each" in the description indicates you bill with units for each additional lesion. I'd appeal.
    Pam Brooks, MHA, COC, PCS, CPC, AAPC Fellow
    Coding Manager
    Wentworth-Douglass Hospital
    Dover, NH 03820

    If you can dream it, you can do it. Walt Disney

  7. #7
    Location
    Columbia, MO
    Posts
    12,531
    Default
    Most payers are using this edit now for surgical service billed with units greater than one. i always bill individual line items, the instruct in the book states "list separately....." I have always been paid when I list it as follows
    17000
    17003
    17003 59
    17003 59
    17003 59
    17003 59
    17003 59
    17003 59
    17003 59
    17003 59
    17003 59
    This shows that 10 independent and separate lesions were destroyed in the same session.

    Debra A. Mitchell, MSPH, CPC-H

  8. Default
    Quote Originally Posted by jgf-CPC View Post
    It is correct that you cannot bill 17003 X10 units. This would mean the patient had hundreds of lesions destroyed. If there were 10 lesions than you would bill 17000 for the first lesion destroyed and 17003 for the rest up to 14. 17004 is billed alone for 15 or more lesions without the 17000 or 17003. Hope this helps!
    Please read the CPT book CORRECTLY. I hope you have not been billing like this for your employer.. if so they have lost countless money.

  9. Default 17003 Excessive Units
    Just new at this and had the same question. On the AAPC practice exam A and others, excessive units that have in the description "second through 14 lesions, EACH (List separately in addition to code for the first lesion". The answer to one of the questions on the exam show destruction of multiple lesions and is coded as follows: 17000 lesion one; 17003 x 10 for a total of 11 lesions. If you are billing 17000 +17003 thinking that 17003 covers everything, then you have been grossly underpaid. The company requesting the refund needs to call the AMA for clarification as they aren't going to listen to the person they think made a mistake. Just my two cents, 8 years later!!

  10. #10
    Location
    Ft. Worth, Texas
    Posts
    108
    Default
    Carol Buck's book states If the patient had six lesions removed, the first one would be reported with 17000 and lesions two through six are reported with 17003 x 5.

    Cathy

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