Wiki Photochemotherapy 96910

[hstefani]

From the description of 96910, it states the physician uses photosensitive chemicals and light rays to treat skin ailments. I have a physician that wants to know who can apply the chemicals. Is it billable if the MA, LVN, or RN applies the chemicals?

I am unable to find out information on this. Any information would be helpful

Thanks!

Heather

 

[hkatie]

Good morning, Heather,

I'm just going to expand a little on Mallory's reply regarding 96567. Keep in mind that 96567 involves premalignant or malignant lesions treatment. It is often described as the "blue light treatment" which is preceded by an in-office application of aminolevulinc acid HCl (Levulan stick) with a 60 minute incubation and then wash off. This isn't a code you would see in a typical psoriasis/eczema phototherapy department.

96912 should only be used if the patient either had a psoralen soak/application or took psoralen pill(s) 90 minutes prior to tx with UVA. Right now this is a more unusual code to use as there has been a shortage of the raw materials needed for psoralen medications. Supplies are coming back slowly. http://www.valeant.com/products/dermatology/index.jsp

Finally, on 96910. Yes, any staff can apply the petrolatum/tar based product before exposure to UVB. I would not let techs make a habit of allowing patients to do it at home prior to tx unless it is tar and the treatment plan is well documented (tar is applied and then washed off at home as most clinics do not have bathing facilities-tar isn't used as much as petrolatum due to the extreme mess of tar and the resulting non-compliance from patients.) RVUs take into account supplies needed for this code, including the petrolatum or tar. Be absolutely sure your techs are documenting this application in the chart at EACH treatment. More than one clinic has been caught with their pants down on this point in the last 18 months and had their treatments downcoded to 96900. As this is a substantially different code w/ a correspondingly different reimbursement amount, this can really hurt a clinic. See page 4: http://www.aad.org/members/publications/_doc/DermCodingConsult_Spring_09.pdf

I know this should go without say, but it's surprising how some of the old literature fails to mention or is even ambiguous on this point: make sure there is a supervising physician on-site during treatment. Also, check with your state's laws about who is allowed to administer the light treatment itself. MAs can in some states, but this is always subject to change and an LPN or RN credential may be required in your state.

Best,

Katie H.