# Heard of Light Hyfrecation?



## losborn (May 26, 2010)

I am auditing a dermatologist who is claiming that he performed "light hyfrecation" on some papules of the face.
He is billing 17000 and 17003.

I can't even find what this is, must less how to code it.  Anybody ever heard of this? Dx for this procedure is 216.3, but primary Dx is Rosacea.


Anybody have a clue?

Thanks
Lin
CPC


----------



## JessH2618 (May 26, 2010)

I am not familiar with "light hyfrecation."  I did a google search and I didn't really get anything concrete on it, but from what I could gather it is a form of destruction, but I think you knew that already.

That being said, 17000 and 17003 should only be used when doing destructions on premalignant lestions (eg, actinic keratoses:  ICD-9:  702.0).  Neither rosacea, nor benign neoplasms, benign of the face would be appropriately billed with those procedure codes.  With the 216.3 diagnosis, I would be more inclined to look at 17110 or 17111 depending on the number of lesions he did destructions on.  

Hope that helps 

Jessica H, CPCD


----------



## losborn (May 26, 2010)

That's the direction I was going in, too. Thanks for the affirmation.

Here is a description I found in a newsletter from HCPro - in case anyone else ever sees this term!  

_"Hyfrecation is actually a really old, outdated term that
a physician may use to describe the cautery (either
chemical or electrical) of tissue. It is not synonymous
with tissue destruction.
This term is actually so old that it isn't listed in
any of the medical dictionaries I own. Fortunately, I
remembered a device that a physician I worked for
30 years ago had. The device, which he referred to as
a “hyfrecator,” was a small black box with leads and
received a credit for in the amount of the cost of the
replaced device.
However, it is noted that there is no OCE edit
in place that will “return to provider” the claim if a
drug administration code is reported without a corresponding
drug product code.
Note that in cases where a patient is on a drug
trial, the medication costs are borne by the manufacturer
and not the payer.
Based upon that guidance, we would suggest you
only bill the payer for the administration, and shift the
cost of the drug back to the manufacturer of the drug.
CMS' Medicare Benefit Policy Manual 100-02 indirectly
addresses this issue. Section 30, “Drugs and Biologicals,”
in Chapter 6, “Hospital Services Covered Under Part B,”
refers the reader to Chapter 15, “Covered Medical and
Other Health Services,” for a description of conditions
for coverage of drugs and biologicals.
In Chapter 15, section 60.1, CMS indicates the
following:
To be covered, supplies including drugs and biologicals,
must represent an expense to the physician or legal entity
billing for the services or supplies. For example, where a
patient purchases a drug and the physician administers it,
the cost of the drug is not covered. However, the administration
of the drug, regardless of the source, is a service that
represents an expense to the physician. Therefore, administration
of the drug is payable if the drug would have been
covered if the physician purchased it.
National Government Services (formally Admini-
Star Federal), a CMS contracted Medicare agent, has
also issued a memorandum titled “Billing Administration
Code without a Drug Line Item” in February
that reflects these instructions.
This memorandum addresses drugs obtained
through manufacturer's patient assistance programs.
Based on these references, it is appropriate to submit
the chemotherapy administration code without a corresponding
drug line item.
Consult your FI or Medicare administrative contractor
for further instruction about this issue.
Injections/infusions < continued from p. 5
Integumentary system, surgery
a wand-like apparatus that conducted an electrical
signal that the physician used to burn a wound to
stop the bleeding, or to destroy warts and lesions.
Physicians may use this device to seal the edges
of a wound or lesion that is oozing or bleeding. Consider
this part of the primary procedure (excision and
removal), and do not code it separately."_

Thanks for your help!

Lin
CPC


----------



## JessH2618 (May 26, 2010)

No problem.

Thank you for posting the information you found on it.  Certainly explains why there was little information out there on it.  

Jessica H, CPCD


----------

