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Destruction, Benign or Premalignant Lesions

17000

Destruction by any method (i.e., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), all benign or premalignant lesions (e.g., actinic keratoses) other than skin tags or cutaneous vascular proliferative lesions, including local anesthesia: first lesion

(17001, 17002 have been deleted. To report, see 17003, 17004)

17003

Second through 14 lesions, each (List separately in addition to code for first lesion.)

(Use 17003 in conjunction with 17000)

17004

Destruction by any method, (i.e., laser surgery, electrosurery, cryosurgery, chemosurgery, surgical curettement), all benign or premalignant lesions (e.g., actinic keratoses) other than skin tags or cutaneous vascular proliferative lesions, including local anesthesia, 15 or more lesions

(Do not report 17004 in conjunction with codes 17000 or 17003)

The appropriate billing is as follows:

For destruction of 14 or fewer lesions, the first lesion is billed using CPT code 17000, 1 number of service; lesions 2 - 14 are billed using code 17003. The number of lesions destroyed should be indicated in the Number of Services claim field.

For destruction of 15 or more lesions, CPT code 17004 should be billed with one number of service. Code 17004 is a global reimbursement. Codes 17000 and 17003 should not be billed in addition to code 17004.

Consistent with the Preferred Medical Doctor Program, destruction of lesions must be appropriate and necessary for the symptoms, diagnosis, or treatment of the member’s medical condition and not primarily for the convenience of the member or the member’s physician.

Last Updated December 2008