Wiki 17110 removals of inflamed & non inflamed SKs

[sjsantjer]

Medicare patient signed an ABN to have 15 non medically necessary SK's removed. Pt also had 2 inflamed SK's removed that were medically necessary. How would you bill for these removals? We removed a total of 17 lesions.

Can we bill
17110 billed to Medicare
&
17110 ABN signed with option 2 checked, billed to Pt (cosmetic procedure)
would this be double dipping?
Thanks for your help.

 

[JesseL]

In new york, medicare requires a secondary diagnosis to represent medical necessity to remove the benign lesions.

For example:

17110- 216.9 Unspecified benign neoplasm & 782.0 Disturbance skin sensation

You need to check the medicare LCD for benign lesion removal in your state to see if the same applies to what I just said.

The one for NY looks like this: http://apps.ngsmedicare.com/lcd/LCD_L27362.htm

If there's no medical necessity like "itching" or "irritating" I would just bill only the 17110 with the inflamed SK (702.11) if your provider can live with the payment difference that they would have paid if you would have coded 17111 (15 or more lesions).

I don't think you can code 17110 twice in one claim form because they have 17111 for 15 or more lesions.