Jolene Posted Wed 18th of December, 2013 12:49:02 PM
"I am billing Medicare for a patient who had 6 total lesions removed by Cryosurgery in our primary care physician's office. I am billing code 17000 for the first lesion removal and then I know I need to bill code 17003. Do I list 17003 five separate times or do I list 17003 one time with 5 units? The CPT book says "each" so I think that means to list the 17003 code five separate times. I also have a level four E & M to bill as an appropriate separate charge from the cryosurgery. I know to use modifiers 25, 51 and 59 appropriately but could use help in knowing the correct order to list 99214 - 25; 17000 - 51, 59; and then the 17003 - 59 code or codes. Thank you!
SuperCoder Answered Wed 18th of December, 2013 14:17:18 PM
You need to make sure the diagnosis is actinic keratoses (702.0) to use these codes. Since 17003 is an add on code you report units with no modifier needed.
17000, 17003 x 5
Make sure documentation would support a 99214, 25 is the correct modifier. To be able to use that high of an E/M level we would expect to see other problems addressed at the encounter.
17003 x 5