Wiki Billing 17110 in ASC

[nglover2001]

My doctor wants to start billing 17110 in the surgical rooms with dx 782.8. Right now we bill them as office procedures. What do type of documentation do I need to support medical necessity? Does anyone else do these in their ASC? Thanks!

 

[airart]

Cpt 17110

Review this CMS document regarding the CPT code 17110 and billing.

“CPT code 17110 should be reported with one unit of service for removal of benign lesions other than skin tags or cutaneous vascular lesions, up to 14 lesions. CPT code 17111 is also reported with one unit of service representing 15 or more lesions…….. Claims for removal of benign skin lesions performed merely for cosmetic reasons may not necessarily need to be submitted to Medicare unless the patient requests that a formal Medicare denial is issued. If a claim is filed, ICD-9 CM code V50.1 (Other plastic surgery for unacceptable cosmetic appearance) should be used in conjunction with the appropriate CPT code.”

Link: http://downloads.cms.gov/medicare-c...tachments/30330_1/DERM008codingandbilling.pdf

 

[nsteinhauser]

We have done these at our ASC; however, it is an 'office based procedure' (payment indicator P2), and the reimbursement from our payers on this code not not cover the cost of doing the case, regardless of diagnosis.