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96567 Photodynamic therapy mult areas

  1. #1
    Question 96567 Photodynamic therapy mult areas
    Medical Coding Books
    On the description for this procedure the coding definition says "each exposure session." (see below) what I'm wondering is a "session" defined as per area on the body this is performed on or per day or what? I have a provider who is doing multiple areas of the body with multiple levulan sticks (one for each area normally). I haven't billed more than one area yet so I'm not sure if this px can be billed in quantities or not. Does anyone out there have experience with this and payment/denials in this area?

    96567: Photodynamic therapy by external application of light to destroy premalignant and/or malignant lesions of the skin and adjacent mucosa (eg, lip) by activation of photosensitive drug(s), each phototherapy exposure session

  2. #2
    Fresno Chapter
    We bill for multiple exposures. If the patienst is getting repositioned for a different site to be exposed to light then it is a different exposure. The insurances are paying for it but some insurance have a frequency limitation so you will have to check your payors.


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