Wiki Procedure code 17000

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We are using code 17000 for destruction of lesion (ex. actinic keratoses 702.0). I referenced Medicare LCD coverage and ICD-9 codes that support medical necessity, but Medicare is denying the procedure as not medically necessary. Any suggestion? Also having trouble with wart tx and payment from Medicare. Your input will be greatly appreciated!:confused:
 
I found a list of acceptable Dx for use with 17000:
078.0 Molluscum contagiosum
078.10 Viral warts, unspecified
078.11 Condyloma acuminatum (added 10/18/2005)
078.12 Plantar wart (new 10-1-2008)
078.19 Other specified viral warts
211.4 Benign neoplasm of rectum and anal canal (added 10-25-2002)
214.0 Lipoma of skin and subcutaneous tissue of face (added 10-25-2002)
214.1 Lipoma of other skin and subcutaneous tissue (added 10-25-2002)
216.0, 216.1, 216.2, 216.3, 216.4, 216.5, 216.6, 216.7, 216.8, 216.9
Benign neoplasm of skin (nevus) code range (10/18/2005)
374.84 Sebaceous cysts of eyelids (added 5-14-2002)
448.0 Hereditary hemorrhagic telangiectasia (added 10-25-2002)
448.1 Nevus, non-neoplastic
608.89 Cyst of penis (added 5-14-2002)
610.8 Sebaceous cyst of breast (added 5-14-2002)
629.8 Other specified disorders of female genital organs (added 5-14-2002) (Description revised 9-22-2006) (deleted 9-22-2006)
702.11 Inflamed seborrheic keratosis
702.19 Other seborrheic keratosis
706.2 Sebaceous cyst
782.0, 782.1, 782.3, 782.4, 782.5, 782.61, 782.62, 782.8, 782.9
Disturbance of skin sensation code range (added 10-25-2002) (10/18/2005)
V10.82 Personal history of malignant neoplasm of other sites; other malignant neoplasm of skin
V10.83 Personal history of malignant neoplasm of other sites; other malignant neoplasm of skin
 
17000 is used for pre malignant lesion such as 702.0 ,"AK's". if the lesion are not premalignant (warts) you have to use 17110-17111.
for skin tags use 11200.
 
Thanks for the thoughts. I am using 17000 for AK's, etc and getting denied. I am using 17110 for wart treatments and getting denied. I am using the same diagnosis list that is listed above. Not sure what to do?!
 
If denial was before notes were requested, I would say to appeal with the supporting documentation. If notes were requested by medicare and they denied claims, Make sure the documentation supports LCD guidelines.
 
I would check your state's LCD on code 17000. If your dx is on the 'covered code' list then I would contact MCR and ask for explanation of denial.
 
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