tci Medicare Compliance & Reimbursement - 2007 Issue 16

REIMBURSEMENT: Keep Number Of Units Straight For 17003 and 17111

Only one diagnosis will get you paid for 17000-17004.Heads up: Relying on your carrier's local coverage determinations (LCDs) could cost you some big repayments later on.CPT 2007 changed the descriptors for some lesion destruction codes. Starting last January, codes 17000-17004 apply to only premalignant lesions. And 17110-17111 apply to only benign lesions. That means the only diagnosis code you can use with 17000-17004 is 702.0 (Actinic keratosis).But many carriers still haven't updated their LCDs, meaning they're still accepting other lesion diagnosis codes for 17000-17004. You might get paid if you use one of those other...

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