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Kent J. Moore

Fam Pract Manag. 2004 Oct;11(9):25-26.

You are watching: Cpt code for cryotherapy of warts

This content conforms come cg-tower.com CME criteria. See FPM CME Quiz.

A local billing and coding experienced told us that just psychiatrists, psychiatric APRNs or those who space enrolled in a psychiatric insurance allowance carve-out (usually behavior health) have the right to submit CPT code 90862, “Pharmacologic management, including prescription, use, and also review that medication through no much more than minimal clinical psychotherapy.” He said that family physicians and other physicians are restricted to the evaluation and also management (E/M) visit codes. Walk CPT do this restriction?

No. In fact, CPT claims that “it is important to acknowledge that the listing of a service or procedure and its code number in a particular section the this publication does not restrict its use to a details specialty group. Any type of procedure or service in any kind of section that this book may be provided to designate the solutions rendered by any qualified physician or various other qualified health treatment professional.”

So, from a CPT perspective, household physicians can submit code 90862. Whether they will acquire reimbursed for it counts on a wellness plan’s payment policy. Some health and wellness plans may use mental health and behavioral health and wellness carve-outs that preclude payment because that 90862 except when billed through a psychiatrist or various other designated mental health experienced such as a psychiatric APRN, as your coding skilled described. This effectively limits the use of this code to those specialties, in spite of the language in CPT quoted above.

For an ext information ~ above the suitable use of password 90862, check out “Pharmacologic management,” FPM, might 2003, web page 17.

When I execute an electrocardiogram (ECG) because that a patience presenting v a symptomatic disease (e.g., chest pain, dizziness and also diaphoresis), what ECG code need to I submit? I have been told the CPT password 93000 is only for a “routine” ECG and, therefore, not suitable in this case. However, I have reviewed CPT’s cardiography codes (93000-93278), and I might not situate a an ext appropriate code than 93000, “Electrocardiogram, program ECG through at the very least 12 leads; v interpretation and report,” tagged through the declared primary symptomatic illness. Am I missing something?

I don’t think so. I agree that 93000 tagged v the declared primary symptomatic illness shows up to it is in the most appropriate way to password the company you’ve described. “Routine” in the descriptor refers to the performance of the ECG (i.e., this ECG is more routine than rhythm strips, tension ECGs, Ergonovine provocation and also microvolt T-wave alternans) rather than the condition of the patient, therefore the code should still it is in valid v symptomatic patients. Also, ns am not mindful of any type of other password that Medicare or other payers would direct you to usage in this situation. In fact, Medicare reimbursed password 93000 nearly 10 million times in 2001, which would certainly not it is in the case if the password was not to be used with symptomatic patients.

Does the ax “biopsy” in the descriptor because that CPT code 11100, “Biopsy that skin, subcutaneous tissue and/or mucous membrane (including simple closure), uneven otherwise listed; solitary lesion,” mean that the code only uses to a partial lesion removal together opposed to a full excision?

“Biopsy” in the paper definition of 11100 does usually mean much less than a full excision. However, in part cases, 11100 can be used also when the biopsy procedure results in the remove of the whole lesion. It counts on the will of the procedure. If the will is to recognize the lesion and/or recognize whether added treatment is necessary, code 11100 would be appropriate, nevertheless of whether the lesion is completely or partially removed. If the intent is to eliminate the lesion, an cut or shave-removal code would be appropriate.

If I carry out cryotherapy on three warts, I understand I need to submit 17000, “Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, operation curettement), every benign or premalignant lesions (e.g., actinic keratoses) various other than skin tags or cutaneous vascular proliferative lesions; very first lesion,” when for the an initial lesion and 17003, “... Second through 14 lesions, each (List separately in addition to code for very first lesion),” with 2 units of company for the other lesions. Yet do I likewise need to connect modifier -59, “Distinct procedural service,” or comprehensive -51, “Multiple procedures,” to 17003?

No, you carry out not require to attach a modifier come 17003. Because the descriptor for 17003 indicates that these are separate lesions, comprehensive -59 is no necessary. Further, 17003 is a designated add-on code, which means that the is “exempt from the multiple-procedure concept,” according to CPT. Note that damage of level warts must be coded with 17110 or 17111 instead.

See more: What Is 12 Liters Equals How Many Quarts Conversion, Liters To Quarts Conversion

If i attempt to start an IV for blood collection in the office (e.g., on an infant suspected the sepsis) but, after several attempts, abort the effort and also send the patient to the hospital for admission, what code(s) need to I submit for the failure attempts?

You need to submit the appropriate IV or venipuncture password (e.g., 36400, “Venipuncture, under period 3 years, necessitating physician’s skill, no to be used for routine venipuncture; femoral or jugular vein”) through modifier -52, “Reduced services,” attached. This modifier suggests that the organization was decreased or eliminated at the physician’s discretion.