Summary & Overview
CPT 17003: Destruction of Premalignant Skin Lesions, Second Through 14th
CPT code 17003 is a critical billing code for dermatology and procedural skin care, representing the destruction of premalignant lesions—such as actinic keratoses—when treating the second through fourteenth lesion in a single session. This code is widely used in office-based dermatology practices and other CMS-approved care settings, reflecting the prevalence of skin lesion management in the United States. The procedure encompasses a range of destruction techniques, including laser surgery, electrosurgery, cryosurgery, chemosurgery, and surgical curettement, and is essential for preventing progression to skin cancer.
Major national payers covering this code include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a comprehensive overview of payer coverage, clinical context, and policy updates relevant to CPT 17003. Readers will gain insights into reimbursement benchmarks, coding nuances, and the role of this code in dermatology and procedural skin care. The analysis also addresses typical sites of service, common clinical indications, and related codes for destruction procedures, offering a clear understanding of how CPT 17003 fits into broader skin lesion management protocols. This summary is designed for healthcare professionals, billing specialists, and policy analysts seeking up-to-date information on coding and coverage for destruction procedures.
CPT Code Overview
CPT 17003 is used to report the destruction of premalignant lesions, such as actinic keratoses, for the second through fourteenth lesion treated during a single encounter. This code covers procedures including laser surgery, electrosurgery, cryosurgery, chemosurgery, and surgical curettement. It is listed separately in addition to the code for the first lesion, reflecting the incremental nature of treating multiple lesions.
Service Type: Destruction procedures on benign or premalignant lesions of the integumentary system.
Typical Site of Service: Most commonly performed in the office setting (POS 11), but may also occur in other CMS-covered locations such as home (POS 12), assisted living (POS 13), group home (POS 14), temporary lodging (POS 16), and custodial care facility (POS 33).
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult presenting to a dermatology clinic with multiple premalignant skin lesions, such as actinic keratoses. The provider evaluates the lesions and determines that destruction is medically necessary. The first lesion is treated and coded with 17000. For the second through fourteenth lesions, each is treated using methods such as cryosurgery, electrosurgery, or laser surgery, and each additional lesion is coded with 17003. The procedure is performed in an office setting (Place of Service 11), but may also occur in other CMS-covered settings such as home, assisted living, or group homes. The workflow includes lesion identification, documentation, selection of destruction method, and post-procedure care instructions.
Coding Specifications
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Modifier
59: Used to indicate a distinct procedural service when multiple procedures are performed on the same day that are not normally reported together. -
Modifier
51: Used to indicate multiple procedures performed during the same session by the same provider.
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