Wiki Chemical Peels and Acne Surgery ?

[Texascoder64]

this is a 2 part question - 1- about chemical peels and 2 about acne surgery.

Need some input about the chemical peel billing - I am only familiar with cpt 17360 that has been covered by Medicare (Novitas our MAC in TX) and covers for acne 706.1, what about these chemical peels codes 15788 are these covered by Medicare? I see we have a fee published on Novitas so I am assuming it can be billed - what dx is acceptable - is it ok for AK's or skin cancers? I could not find an LCD or National policy for these CPT codes.

Also, do you know if it is acceptable for the aestheticians in the practice to bill the acne surgery code 10040 when they are doing the microderms- maybe a milia extraction occasionally? The other part of this question is would a physician have to diagnose "acne" first, before the acne surgery could be performed by an aesthetician , and billed to insurance? - in other words - a person could not just walk in off the streets and say they want a "microdermabrasion" and then if they have insurance - get an CPT 10040 billed to their insurance company with 706.1 - right?

Thank you!
Lisa

 

[CatchTheWind]

For chemical peel of AKs, we use 17004. We have never used a chemical peel for skin cancer, but if you did, I you could use the malignant destruction codes (172xx).

On question #2, my understanding is that the esthetician can perform milia extraction and you can bill it as acne surgery under the doctor's NPI if the doctor has diagnosed it, since the esthetician is working as a physician-extender.

 

[pbest]

Can a esthetician do the acne surgery and be supervised by a PA ?

 

[CatchTheWind]

Yes, as long as you meet incident to rules (if the payer requires them) and bill under the PA.

 

[ssevans78]

on the code 10040 does it have to be and incision and then extraction or can it just be an extraction with the extractor tool?

and as far as billing under the PA is that for any insurance or just for medicare?