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2007 CPT 2007 CPT Dermatology Dermatology

Descriptor Descriptor ChangesChanges

Destructions ofDestructions of

Benign and Benign and

Premalignant Premalignant

LesionsLesions

Destruction CodesDestruction Codes

17000170001700317003170041700417110171101711117111

Destruction Destruction procedures will be procedures will be

coded by coded by

Type of lesion(s)Type of lesion(s)

Codes for Codes for premalignantpremalignant

lesions lesions andand

Codes for benign Codes for benign lesionslesions

What stays the sameWhat stays the same

Destruction DefinitionsDestruction Definitions• ablationablation• with or without with or without curettementcurettement

Same InclusionsSame Inclusions

includes includes anesthesiaanesthesia

closure not closure not requiredrequired

electrosurgeryelectrosurgery curettementcurettement laserlaser cryosurgerycryosurgery chemicalchemical

Same Surgical MethodSame Surgical Method

What changedWhat changed170001700017003170031700417004

Used only forUsed only for““Premalignant”Premalignant”

LesionsLesions

Updated CPT Updated CPT

DescriptorDescriptor forfor

17000 series17000 series

Destruction (eg, Destruction (eg, laser surgery, laser surgery, electrosurgery, electrosurgery, cryosurgery, cryosurgery, chemosurgery, chemosurgery, surgical surgical curettement) curettement) premalignant premalignant lesionslesions

Same coding useSame coding use

1700017000 – 1 – 1stst lesion lesion 17003 17003 – 2– 2ndnd - 14 - 14 lesions, eachlesions, each

1700417004 – 15 or more – 15 or more lesionslesions

Same ApplicationSame Application

1700317003 never used never used alonealone

1700317003 used with used with 1700017000 only only

Same CPT RulesSame CPT Rules 1700317003 is add-on is add-on codecode

add-on codes areadd-on codes aremodifier exemptmodifier exempt

Same CPT RulesSame CPT Rules

1700417004 used alone used alone 1700417004 never used never used

with with 1700017000 oror 1700317003

As of 2007 CPTAs of 2007 CPT

17000 Series are 17000 Series are

only used for only used for

premalignant premalignant lesionslesions

Premaligant examplesPremaligant examples destruction of 5destruction of 5actinic keratosis actinic keratosis (AKs) of face(AKs) of face

Use: 17000Use: 17000

17003 x417003 x4

Premaligant examplesPremaligant examples

Destruction of AKs:Destruction of AKs: 6 on forehead, 6 on forehead, 5 on scalp, 5 on scalp, 1 on right cheek, 1 on right cheek, 3 on left dorsal hand3 on left dorsal hand

Use: Use: 1700417004

2007 Coding 2007 Coding Change for Benign Change for Benign

LesionsLesions

CPT Codes for CPT Codes for Benign LesionsBenign Lesions

1711017110 1711117111 used only for benign used only for benign lesions other than lesions other than cutaneous vascular cutaneous vascular lesionslesions

Updated 2007 CPT Updated 2007 CPT DescriptorDescriptor

17110171101711117111

Destruction (eg, laser Destruction (eg, laser surgery, electrosurgery, surgery, electrosurgery, cryosurgery, cryosurgery, chemosurgery, surgical chemosurgery, surgical

curettement), curettement), of all of all benign lesions other benign lesions other than skin tags or than skin tags or cutaneous vascular cutaneous vascular lesionslesions

Same Code UseSame Code Use

1711017110 – up to – up to 14 lesions14 lesions

1711117111 – 15 or – 15 or more lesionsmore lesions

Same ApplicationSame Application

stand alone codes stand alone codes used separately, used separately, not togethernot together

ExamplesExamples destruction of 2 destruction of 2 irritated irritated seborrheic seborrheic

keratoseskeratoses

Use:Use: 1711017110

ExamplesExamples

destruction of 4 destruction of 4 verrucae vulgarisverrucae vulgaris

Use:Use: 1711017110

ExamplesExamples destruction of 8 destruction of 8 irritated seborrheic irritated seborrheic keratoses & 7 keratoses & 7 verrucae vulgarisverrucae vulgaris

Use: 17111Use: 17111

Laser CodesLaser Codes

No change to No change to laser destruction laser destruction codescodes

Same Same CPT DescriptorCPT Descriptor

forfor

Laser CodesLaser Codes

17106 series17106 series

Laser CodesLaser Codes destruction of destruction of cutaneous cutaneous vascular vascular proliferative proliferative lesions (eg, laser lesions (eg, laser

technique)technique)

Same Laser CodesSame Laser Codes

1710617106 1710717107 1710817108

Same coding useSame coding use 1710617106 - less than - less than 10 10 sq cmsq cm

1710717107 -- 10.0 10.0 -- 50.0 50.0 sq cmsq cm

1710817108 – over 50.0 – over 50.0 sq cmsq cm

Same applicationSame application used for:used for:•port wine stainsport wine stains• strawberry strawberry hemangiomashemangiomas

Same applicationSame application notnot used for: used for:• acneacne• rosacearosacea• telangiectasiatelangiectasia

QuestionsQuestions

True or False?True or False?

1. Report code 17110 1. Report code 17110 for the destruction for the destruction of 3 irritated of 3 irritated seborrheic seborrheic keratosiskeratosis


2. Codes 17000 – 2. Codes 17000 – 17003 are used 17003 are used only to report only to report destruction of destruction of actinic keratosesactinic keratoses


3. Report code 11900 3. Report code 11900 for the for the

administration of administration of local anestheia in local anestheia in conjunction with conjunction with the the destruction destruction codes codes


4. For the treatment 4. For the treatment of 15 or more of 15 or more actinic actinic keratosis, keratosis, report report 17000 17000 with 17004.with 17004.


5. When treating 5. When treating warts with laser warts with laser destruction, use destruction, use codes 17106-codes 17106-17108. 17108.

AnswersAnswers

1. 1. TRUETRUEAccording to the According to the descriptor change descriptor change in CPT 2007, codes in CPT 2007, codes 17110 and 17111 17110 and 17111 are used for all are used for all benign lesions.benign lesions.

2. 2. TRUETRUE According to theAccording to the

descriptor change descriptor change in CPT 2007, codes in CPT 2007, codes 17000-17004 are 17000-17004 are

used only for the used only for the destruction destruction of of premalignant premalignant lesions.lesions.

3. 3. FALSEFALSEThe administration The administration of local anesthesia of local anesthesia is included in all is included in all

destructions as destructions as well as well as biopsies, biopsies, excisions excisions and and shave removals.shave removals.

4. 4. FALSEFALSECode 17004 is used Code 17004 is used

for 15 or more for 15 or more lesions. lesions. It is a stand It is a stand alone alone code and not code and not reported with 17000 reported with 17000 or or 17003.17003.

5. 5. FALSEFALSEThe laser destruction The laser destruction

codes 17106-17108 are codes 17106-17108 are used only for used only for cutaneous cutaneous vascular vascular proliferative proliferative lesions. lesions. Destruction of Destruction of warts warts would be reported would be reported with with codes 17110-17111.codes 17110-17111.

ConclusionConclusion

CPT changes for CPT changes for 20072007

17000, 17003, 17000, 17003, 17004 are used 17004 are used only for only for

premalignant premalignant lesionslesions


Codes 17110 and Codes 17110 and 17111 are used for 17111 are used for the destruction of the destruction of benign lesions.benign lesions.


No change in No change in the use of codes the use of codes 17106-17108.17106-17108.

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codes 17110