Don't have a TCI SuperCoder account yet? Become a Member >>

Regular Price: $24.95

Ask An Expert Starting at $24.95
Have a medical coding or compliance question? Don’t sacrifice your valuable time to endless research. Choose Ask an Expert to get clear answers from the TCI SuperCoder team. And here’s a tip for the budget-conscious: Select the 12-question pack to get the best rate per question!

Browse Past Questions By Specialty

+View all

Phototherapy

Karin Posted Tue 02nd of October, 2012 01:18:24 AM

Can you review the below note for applying code 96900. I have never used this code before so need some guidance. Thank You!

Impression/Plan:
Alopecia Areata: discrete non-scarring patches of hair loss distributed on the right
parietal scalp, left parietal scalp, and scalp.

Plan: Phototherapy Treatment.
Written consent obtained. The risks were reviewed with the patient including but
not limited to: burn, pigmentary changes, pain, blistering, scabbing, redness,
increased risk of skin cancers, and the remote possibility of scarring.
The patient received NBUVB
Treatment Number: 5
Total Treatment Time: 16:40

SuperCoder Answered Tue 02nd of October, 2012 15:07:33 PM

This is correct. Look out for this attached article form coding alert.

For patients with vitiligo (709.01), your dermatologist may use narrow band UVB phototherapy.

The dermatologist administers phototherapy two to three times per week for several months until the patient achieves repigmentation of the skin. For this procedure, you need to pinpoint what types the physician used (UVA, UVB) and the varying wavelengths.

To choose the appropriate code, ask yourself these two questions:

Question 1: Did the dermatologist use tar or petrolatum combined with the light treatment?

If he did, then code 96910 (Photochemotherapy; tar and ultraviolet B [Goeckerman treatment] or petrolatum and ultraviolet B). During this procedure, the dermatologist administers ultraviolet B light, with dosages carefully increased as the treatment progresses, leading to longer times spent under the light source.

Watch out: When the patient applies the treatment herself, you would report 96900 (Actinotherapy [ultraviolet light]) instead.

Check your payer for their rules. For instance, Aetna considers treatments for vitiligo cosmetic if it does not affect the underlying condition and does not result in improved protection against skin cancer. Specifically, micropigmentation (tattooing) and depigmentation (with monobenzylether of hydroquinone/monobenzone) are considered cosmetic.

Question 2: Did the dermatologist prescribe psolarens combined with ultraviolet A (UVA) light therapy?

If so, then use 96912 (Photochemotherapy; psoralens and ultraviolet A [PUVA]). If your dermatologist doesn't use tars, petrolatum or psolarens with the light treatment, the code that remains is 96900 (Actinotherapy [ultraviolet light]).
The difference: UVA phototherapy is usually given in conjunction with a light-sensitizing tablet called psoralen (PUVA therapy). Sometimes a light-sensitizing cream or lotion containing psoralen can be used in localized skin areas (such as feet [topical PUVA]). On the other hand, UVB phototherapy utilizes the sunburning part of the UV spectrum.

Don't take risks: If you code either 96910 or 96912 when your dermatologist uses only a light source in the treatment or the patient applies a topical agent, you risk being accused of misrepresentation of service. It could constitute a fraudulent claim under the Federal False Claims Act.

Related Topics