Summary & Overview
HCPCS S0117: Tretinoin topical, 5-gram
HCPCS Level II code S0117 denotes a 5-gram topical formulation of tretinoin, a widely used topical retinoid for dermatologic conditions. Nationally, this code identifies dispensing of a prescription topical medication and is relevant to billing in outpatient dermatology clinics, ambulatory care, and pharmacy settings. Accurate coding of S0117 supports claims processing, inventory tracking, and clinical documentation tied to topical tretinoin therapy.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find context on where this code is applied clinically, how it maps to service lines and sites of service, and what to expect in payer coverage considerations. The publication provides benchmarks and policy-relevant notes for national billing practices, summarizes common modifiers and payer interactions, and situates S0117 within dermatology dispensing workflows.
This summary is intended for billing professionals, practice managers, and clinical staff seeking concise guidance on the clinical meaning and administrative use of HCPCS Level II code S0117. It does not provide state-specific guidance.
Billing Code Overview
HCPCS Level II code S0117 represents Tretinoin, topical, 5 grams, a topical retinoid medication commonly used for dermatologic indications such as acne and photoaging. The service type is topical medication dispensed. The typical site of service is outpatient dermatology clinics, ambulatory care settings, and retail or specialty pharmacies where topical prescription medications are provided to patients.
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adolescent or adult with localized acne or focal photodamage seeking topical therapy via a dermatology clinic. The clinician dispenses or supervises application of a small quantity of topical tretinoin (S0117 — 5 grams) during an office visit. The workflow: history and skin exam are performed; diagnosis is documented (for example, acne vulgaris); patient education on application, expected effects, and adverse reactions is provided; the medication is either provided from office stock or a sample is given under the S0117 billing descriptor; follow-up is scheduled to assess response and tolerance. Nursing staff may prepare the tube and document lot/expiration when dispensing. Typical sites of service are outpatient dermatology clinics, primary care offices, or specialty ambulatory clinics where topical medications are dispensed directly to the patient.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard reporting when no special circumstances apply |
22 |