Primary Care Coding Alert

Question: The January 2007 Family Practice Coding Alert stated that codes 17000 and 17004 now only apply to premalignant lesions, and code 17110 should be reported for benign lesions other than skin tags or cutaneous vascular proliferate lesions. Does this mean that I can no longer use 17000 for warts or seborrhic keratoses?

Utah Subscriber Answer: You are correct. CPT 2007 has changed the code descriptors, which now read as follows:

- 17000 -- Destruction (e.g., laser surgery, electro- surgery, cryosurgery, chemosurgery, surgical  curettement), premalignant lesions (e.g., actinic keratoses); first lesion

- 17004 -- Destruction (e.g., laser surgery, electrosurgery, cryosurgery,  chemosurgery, surgical curettement), premalignant lesions (e.g., actinic  keratoses), 15 or more lesions

- 17110 -- Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags  or cutaneous vascular lesions; up to 14 lesions. The AMA publication CPT Changes 2007: An Insider's View states, -Codes 17000-17004 have been revised to limit reporting these procedures to the destruction of premalignant lesions by any one of the described methods (laser electrosurgery, cryosurgery, chemosurgery, or surgical curettement). In tandem with these revisions, codes 17110 and 17111 have been revised to limit reporting these procedures solely for the destruction of benign lesions.-

In addition, the publication notes that CPT added a cross-reference following code 17003 -to indicate that because plantar warts are not considered to be of a premalignant nature, the destruction of these lesions is reported with codes 17110 and 17111.-

This advice is effective as of Jan. 1, 2007, so you should report any lesion destructions with 2007 dates of service using this new guidance.   Answers to You Be the Coder and Reader Questions reviewed by Kent J. Moore, manager of Health Care Financing and Delivery Systems for the American Academy of Family Physicians in Leawood, Kan.