General Surgery Coding Alert

A reader question, "Don't Ignore Patient Status for WC Claims" (General Surgery Coding Alert Vol. 11, No. 8), asked how to code the laser treatment of a keloid.

The answer advised, "For the laser treatment, 17000 (Destruction [e.g., laser surgery, electrosurgery,cryosurgery,chemosurgery, surgical curettement], premalignant lesions [e.g., actinic keratoses]; first lesion) may be the most appropriate code to report. The question does not explain how your surgeon used the laser to treat the scar. Assuming that this was partial destruction with subsequent excision, 17000 would be the best code."

Correct coding: For the laser treatment, you should report 17110 (Destruction [e.g., laser surgery, electrosurgery,cryosurgery, chemosurgery,surgical curettement], of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions), assuming the treatment was partial destruction with subsequent excision. Code 17110 is the correct code for the destruction of benign lesions.

Why: You should only use 17000 for destruction of premalignant lesions. Plus, many payers only accept the diagnosis of actinic keratosis (702.0, Actinic keratosis) with 17000. This is not proper coding for keloid treatment.

Special thanks to reader Janice Rose, office manager for Drs. Rose, Thomas, and Wilmoth in Tazewell, Tenn.,for catching the error.