How to Bill CPT Code 17000 Correctly & Effectively
Key Takeaways
- What 17000 CPT Code Covers: This code is used for the destruction of premalignant skin lesions such as actinic keratosis, typically via cryosurgery.
- Session Duration Requirements: While there’s no time limit, documentation must reflect the procedure and site treated.
- Who Can Use the Code: Dermatologists, family physicians, and other qualified healthcare professionals?
- Best Practices for Proper Use: Clearly document the number and types of lesions treated and specify the method used.
- Example of Real Usage: A patient presents with unique actinic keratosis on their courage. The provider uses cry therapy to treat the lesion. CPT code 17000 is billed.
What Is the 17000 CPT Code?
CPT code 17000 refers to the destruction of a single premalignant lesion using a method such as cryosurgery, laser, or chemical treatment. Allowing to the 17000 CPT code descriptions, this code put on to the first lesion only.
If multiple lesions are treated, additional codes (like 17003) must be appended.
Who Can Bill CPT Code 17000?
The following healthcare professionals can bill CPT 17000:
- Dermatologists
- General and family physicians
- Nurse practitioners and physician assistants (within scope)
- Plastic surgeons or oncologists (when skin lesions are involved)
All healthcare professional must make sure that documentation supports the diagnosis and medical necessity.
Services Covered Under 17000 CPT Code
When billing 17000, the services typically include:
- Assessment of the lesion
- Destruction via cry therapy, electro surgery, or other technique
- Post-treatment wound care and documentation
This does not cover biopsy, pathology, or cosmetic removal.
Time Requirements (If Applicable)
CPT code 17000 is procedure-based, not time-based. However, the documentation should indicate the procedure was performed completely and specify:
- Location of the lesion
- Method of destruction (e.g., cryosurgery)
- Any follow-up instructions
Modifier Use with CPT Code 17000
Does CPT code 17000 needs a modifier?
It may. Use:
- Modifier 59 when different lesions are preserved at different sites
- Modifier 25 if a separately identifiable E/M service is also provided
Example:
If the healthcare professional performs an E/M visit and also destroys a lesion, use 17000-25 with the E/M code.
Common Billing Mistakes to Avoid
- Billing 17000 for more than one lesion (use 17003 for each additional lesion)
- Failing to document the number and location of lesions
- Using 17000 for benign lesions (use appropriate benign destruction codes instead)
- Not applying modifiers when services overlap (e.g., with E/M)
Reimbursement Rates for 17000 CPT Code
Reimbursement may vary depending on payer and geography. On average:
- Medicare: $50 – $60
- Private Insurance: $65 – $90
- Patient Self-Pay: $100 – $160 (based on provider pricing)
Always confirm with payer contracts. CPT code 17000 is often FSA-eligible if medically necessary.
Variance between CPT Code 17000 and Related Codes
CPT Code | Description |
17000 | Destruction of 1 premalignant lesion |
17003 | Each additional premalignant lesion (up to 14) |
Destruction of 15+ benign lesions |
Understanding the differences helps avoid miscoding. CPT code 17000 vs 17110 regularly confuse providers, 17110 is for benign, not premalignant lesions.
Final Thoughts
CPT code 17000 is a common dermatologic procedure code, but accurate documentation and coding are essential. Avoid billing errors by:
- Knowing how to use it with 17003 for additional lesions
- Including lesion count and type in documentation
- Appending proper modifiers when needed
As medical billing professionals, we’ve seen denials happen simply due to missing modifiers or unclear lesion documentation. Don’t let small errors reduce your revenue.
Disclaimer: This article is for informational purposes only. Always refer to current AMA CPT code guidelines and payer rules before billing.
Frequently Asked Questions (FAQs)
CPT code 17000 is used to bill for the destruction of a single premalignant skin lesion, such as actinic keratosis, typically using cry therapy or electro surgery.
Yes. Use 17000 for the first lesion and 17003 for each additional premalignant lesion (up to 14) treated during the same session.
Yes, if the procedure is deemed medically necessary. Patients can often use FSA or HSA accounts to cover out-of-pocket costs.
Sometimes. Use Modifier 25 if an E/M service is provided on the same day. Use Modifier 59 for different processes performed at different sites.
CPT code 17000 typically has a 10-day global period, meaning related follow-up care within this timeframe may not be separately billable.
CPT 17000 is used for premalignant lesions, while CPT 17110 is used for the destruction of benign lesions such as warts or seborrheic keratosis.
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