Summary & Overview
CPT 17004: Destruction of 15 or More Benign or Premalignant Skin Lesions
CPT code 17004 represents the destruction of 15 or more benign or premalignant skin lesions, most commonly actinic keratoses, using methods such as laser, electrosurgery, cryosurgery, chemosurgery, or surgical curettement. This code is significant in dermatology, as it addresses the need for efficient treatment of multiple lesions in a single session, which is frequently encountered in clinical practice. The procedure is typically performed in an office setting by dermatologists and procedural dermatology specialists.
This publication provides a comprehensive overview of CPT code 17004, including its clinical context, billing benchmarks, and recent policy updates. Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will gain insights into payer coverage, coding nuances, and the role of this code in dermatology practice. The summary also highlights related codes for destruction of fewer lesions, offering a broader perspective on procedural coding for skin lesion management. The information is designed to support healthcare professionals, administrators, and policy analysts in understanding national trends and requirements for this dermatology procedure.
CPT Code Overview
CPT code 17004 is used to report the destruction of all benign or premalignant skin lesions, such as actinic keratoses, when 15 or more lesions are treated during a single session. This procedure may involve various methods, including laser surgery, electrosurgery, cryosurgery, chemosurgery, or surgical curettement. It is classified as a surgical dermatology procedure within the integumentary system. The typical site of service for this code is the office setting (Place of Service 11), where dermatologists and procedural dermatology physicians commonly perform these treatments.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult presenting to a dermatology office with multiple areas of rough, scaly skin lesions diagnosed as actinic keratoses. The provider evaluates the patient and determines that 15 or more lesions require destruction due to their premalignant nature. The procedure is performed in the office setting using methods such as cryosurgery, electrosurgery, laser surgery, chemosurgery, or surgical curettement. The workflow includes lesion identification, documentation, informed consent, and destruction of all identified lesions during a single session.
Coding Specifications
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Modifier
59: Distinct Procedural Service. Used when a procedure or service is distinct or independent from other services performed on the same day. -
Modifier
51: Multiple Procedures. Used when multiple procedures are performed during the same session by the same provider.
| Modifier Code | Description |
|---|---|
59 | Distinct Procedural Service |