I'm trying my hand at dermatology coding and I notice she'll use both actinic
keratosis and actinic dermatitis as the patients diagnosis? What is the
difference? Also, I can pull up actinic keratosis (701.1)but I can't seem to
pull up actinic dermatitis, just dermatitis. Any advice? Thanks.
I just started coding for a dermatologist and I didn't realize how tricky it can be. I am finding it hard to differential the procedure codes to use on warts, acne, moles, lesions and skin tags! Is there a good resource out online that can explain all the differences to me so I know when to use 17000 vs. 17110, etc? Thanks!
This might help to shed a little light on your situation.
The destruction of lesions codes have been revised to differentiate those codes used for premalignant lesions and those used for benign lesions.
The 1700x group of codes will be used only for treatment of premalignant lesions:
CPT® Code Description
-17000 Destruction (e.g., laser surgery, electrosurgery, cryosurgery,
chemosurgery, surgical curettement), premalignant lesions
(e.g., actinic keratoses); first lesion
-17003 Second through 14 lesions, each (list separately in
addition to code for first lesion)
-17004 15 or more lesions
For this set of codes, you should always expect to use the ICD-9 code 702.0x (actinic keratosis).
There is some controversy in the academic world regarding actinic keratoses. Some believe they are pre-cancers, while others believe they are simply early cancers. All agree, however, that they are medically necessary to treat before they become invasive. As such, there is generally insurance coverage for these services.
The 1711x group of codes will be used only for treatment of benign lesions:
CPT® Code Description
-17110 Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular lesions; up to 14
-17111 15 or more lesions
Coverage decisions for 17110 and 17111 should be based on medical necessity.
Some examples of diagnosis that might be used are below.
216.x Benign skin lesions
702.1x Seborrheic keratosis
702.11 Inflamed seborrheic keratosis – can be painful, itchy, may bleed
and can cause illness
078.0 Molluscum contagiosum – a public health problem
078.10 Warts – can be disabling and disruptive to ADLs
078.11 Genital Warts – can be a public health nightmare as they can be
706.2 Cyst – may be draining or inflamed
Great information. I have a chart where the surgeon does CO2 laser ablation on 250 actinic keratosis lesions on neck, face, back, axilla chest, and abdomen. Is it correct that CPT® 17004 covers all 250 lesions?