Wiki Need units for 17003?

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Truely if you read the CPT book you do not bill units, it states to "list separately"
I have always billed
17000
17003
17003 59
17003 59
17003 59
17003 59
I have compared reimbursements many times and this on the whole seems to pay better. I have instructed ohters to bill this way and all have told me their reimbursement went up more times than not.
 
17003 Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); second through 14 lesions, each (List separately in addition to code for first lesion)

Coding 17000 and 17003 x5 is correct. There is no rational for 17000 + 17003 + 17003 to pay more than 17000 + 17003x2. If you are getting paid more for listing separately it's just because the -59 is bypassing that payer's system payment methodology. It's not money that you are due.
 
It is correct to list EACH as that is what the code states. This is not a quantity distributed service. Units are for quntity distrubuted codes (it states this in the manual), when you put 5 units it signifies the same lesion 5 times. This is incorrect. You destructed 5 independent lesions so you list them separately and that is why the reimbursement is higher. It is money you are due.
 
17003

I do agree with you Debra. I should have been more complete with my answer, I was directing it more towards the fact that 17003 is for each rather than whether to use units or 59 modifiers. In my experience some of the payers want it with 59 and some will only take it as units.
 
The -59 is incorrect, you should only bill with units (up to 13), you are setting yourself up for an audit and are most likely bypassing payers edits by appending -59, which CAN affect reimbursement. Your rationale about quantity billing does not apply just by virtue of the code nomenclature .... IMHO, from a payer's perspective ...
 
Please explain what you mean "by virtue of the codes nomenclature". Billing with units is not correct as surgical procedures do come as quantity distributions. The code states each and each is not a quantity. every 15 minutes is a quantity so 30 minutes is 2 units.
 
In the 2010 Step-By-Step Medical Coding by Carol J Buck on page 416 it states "If the patient had six lesions removed, the first one would be reported with 17000 and lesions two through six are reported with 17003x5. In the AAPC coding course we had to list it as 17003x5 on the tests and workbooks.

I also went to a seminar where we were told to use units for drugs or time codes only. She used 90472 as an example.

So which is right? I had a problem with BCBS of Texas paying 90472 when listed separately, filed appeals and was told by a rep from BCBS to list 90472 and how many units, this way the code would not be denied as a duplicate.

Very confusing.

Cathy
 
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