Wiki Can I use 17110 instead of 54050

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JesseL

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Provider used silver nitrate for chemical destruction of a lesion on penile shaft.

The stupid thing with the patient's insurance is he'd have to foot a $150 copay if I bill it as 54050 (chemical destruction, simple). But the code 17110 does not carry a co-pay. Weird since both codes are basically the same aside from location specification.

Can I just use 17110? I mean it is technically on the "skin" of the penis shaft.
 
I think not. Remember as coders we're supposed to code to the highest specificity and to select the code based on provider's documentation. As billers, this is difficuilt to do as we know the financial impact. In your case, whether or not it's fiscally beneficial to the patient, you are bound to choose the code that best reflects what was done; therefore 54050. Hope others comment.....
 
Would it be bad if I just code it as a E/M then.

History taken meets 99213

and for MDM, it's a new problem, and managment option selected is "Minor surgery with no identified risk factors"

So technically I can bill 99213 based on this?
 
In the CPT book under the header for destruction it states:
for destruction of lesions in specific anatomical sites see 40820, 46900-4617, 46924, 54050-54057, 54065, 56501, 56515, 57061, 57065, 67850, 68135.
The book is directing you to use the site specific codes, you really have no choice but to follow the rules, the patient will have to pay the patient responsible amount.
 
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