Summary & Overview
CPT 96922: Excimer Laser Therapy for Psoriasis, >500 sq cm
CPT code 96922 designates excimer (ultraviolet) laser therapy for psoriasis when the total treated area exceeds 500 square centimeters. This procedural dermatology code is used nationally by dermatology clinics and outpatient facilities to capture high-area phototherapy treatments for patients with localized or widespread psoriatic plaques. The code matters because it differentiates intensity and scope of laser treatment from smaller-area services, which can affect billing, coverage determinations, and utilization tracking for phototherapy services.
Key payers in this national context include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for excimer laser psoriasis treatment, common payer considerations, and the typical sites where this service is delivered. The publication includes benchmarks and policy-related notes where available, plus coding and billing considerations tied to service area thresholds.
This summary provides clinicians, billing professionals, and policy stakeholders with a focused briefing on the intent and clinical use of CPT code 96922, the primary service setting, and which major payers are relevant to coverage and reimbursement discussions. Data not available in the input will be identified and omitted from detailed tables.
Billing Code Overview
CPT code 96922 describes treatment of psoriasis using an excimer (ultraviolet) laser for a total treatment area greater than 500 square centimeters. The service is a procedural dermatologic therapy targeted to affected skin surfaces.
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Service type: Procedural dermatology — excimer laser phototherapy
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Typical site of service: Dermatology clinic or outpatient procedural setting
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with chronic plaque psoriasis involving multiple body regions where prior topical therapies and/or systemic treatments are inadequate, contraindicated, or not tolerated. The patient presents to a dermatology clinic for targeted phototherapy using an excimer ultraviolet B laser when a total treatment area exceeds 500 square centimeters. The workflow begins with a focused evaluation and documentation of psoriasis extent, prior treatments, and consent. The provider photographs or maps treatment areas, measures total surface area to confirm it exceeds 500 sq cm, and programs the excimer laser with dose parameters based on skin type and lesion thickness. Protective eyewear is provided to patient and staff; surrounding skin may be shielded. The provider or trained clinician delivers treatment to involved plaques, documents number of fields, energy delivered, response, and any adverse effects. Typical follow-up visits occur weekly to biweekly to assess response, adjust dosing, and determine additional sessions. Billing uses 96922 for cumulative treated area over 500 sq cm, with appropriate diagnosis codes for psoriasis and modifiers as applicable for professional or technical components, unusual service circumstances, or multiple procedures.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When reporting only the professional component of the service if the facility or another entity provides the technical component |