# New PDT (96576 and 96574) codes



## lanam (Nov 17, 2017)

Does anyone know how these new codes will affect billing?  If the provider applies the levulan but the nurse applies the light treatment what should we bill, 96567 or 96576?  

Thank you,


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## ellzeycoding (Nov 17, 2017)

The new codes are *96573 *and 96574.    96567 was revised to include by staff in the definition.

97574 is a new code that combined PDT and debridement.

In regard to your question...

96567 is being reduced to include chemical application and light treatment *by staff only* (under general supervision of provider on-site).  IN other words, the physician is not directly involved in providing any portion of the treatment that day.

96573 is when physician applies chemical and does the light

At least that is my take so far.

REVISED ANSWER - I am working with the AAD for clarification on this.


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## ellzeycoding (Dec 1, 2017)

I'm collaborating with the American Academy of Dermatology on a more clear response to the original question.

In speaking wish their coding expert, the physician must be *directly* involved with applying the chemical and directing/performing the light exposure session in order for 96573 to be billed.

They are going to seek some clarification/recommendation from members of their coding panel, on how to handle the split-effort scenario (i.e., physician/staff performing PDT).


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## CatchTheWind (Dec 14, 2017)

I just noticed that FCSO (Florida Medicare) does not include 96573 in their 2018 fee look-up tool.  Does this mean that they will not recognize & pay this new code?


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## ellzeycoding (Dec 14, 2017)

CatchTheWind said:


> I just noticed that FCSO (Florida Medicare) does not include 96573 in their 2018 fee look-up tool.  Does this mean that they will not recognize & pay this new code?



It's there.. for example


https://medicare.fcso.com/Data_files/0394669.pdf

Doesn't appear to be in the "lookup tool", but it's in the downloadable versions of their fee schedules.

Yes, all Medicare payors will pay for it.


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## ellzeycoding (Dec 15, 2017)

Here is the free 20-minute mini-webinar I just produced on the new PDT codes.

When you register online, it sends an email with a link to the handout.

https://register.gotowebinar.com/register/5365322466582127618


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## ellzeycoding (Dec 15, 2017)

Here is a free 20-minute mini-webinar I just produced on the new PDT codes.

When you register online, it sends an email with a link to the handout.

https://register.gotowebinar.com/register/5365322466582127618


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