How To Use CPT Code 17004

CPT 17004 refers to the destruction of 15 or more premalignant lesions using various techniques. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 17004.

1. What is CPT 17004?

CPT 17004 is a medical billing code used to describe the destruction of 15 or more premalignant lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, laser surgery, or surgical curettement. This code is used by medical professionals to accurately document and bill for this specific procedure.

2. 17004 CPT code description

The official description of CPT code 17004 is: “Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses), 15 or more lesions.”

3. Procedure

The 17004 procedure involves the following steps:

1. The patient is appropriately prepped for the procedure.
2. Anesthesia, such as local anesthesia, may be administered if necessary.
3. The provider destroys 15 or more premalignant lesions using a chosen method, such as laser surgery, electrosurgery, cryosurgery, chemosurgery, or surgical curettement.
4. The surrounding tissue is preserved during the destruction process.
5. The procedure is completed, and the patient is monitored for any complications or side effects.

4. Qualifying circumstances

Patients eligible to receive CPT code 17004 services are those with 15 or more premalignant lesions, such as actinic keratoses, that require destruction using one of the specified techniques. The provider must determine that the destruction of these lesions is medically necessary and appropriate for the patient’s condition.

5. When to use CPT code 17004

It is appropriate to bill the 17004 CPT code when a provider has performed the destruction of 15 or more premalignant lesions using one of the specified techniques, and the procedure is deemed medically necessary for the patient’s condition. This code should not be used for the destruction of fewer than 15 premalignant lesions; in such cases, CPT codes 17000 and +17003 should be used instead.

6. Documentation requirements

To support a claim for CPT 17004, the following information should be documented:

• Patient’s medical history and diagnosis, indicating the presence of 15 or more premalignant lesions requiring destruction.
• A detailed description of the procedure performed, including the technique used for lesion destruction and the number of lesions destroyed.
• Any anesthesia administered during the procedure.
• Post-procedure monitoring and follow-up care, if applicable.
• Any complications or side effects experienced by the patient.

7. Billing guidelines

When billing for CPT code 17004, it is essential to follow the appropriate guidelines and rules. Do not report CPT 17004 in conjunction with CPT codes 17000-17003. Ensure that the documentation supports the medical necessity of the procedure and accurately reflects the services provided. Additionally, be aware of any payer-specific requirements or guidelines that may apply to the billing of CPT 17004.

8. Historical information

CPT 17004 was added to the Current Procedural Terminology system on January 1, 1998. There have been several updates to the code since its addition, with the most recent change occurring on January 1, 2007.

9. Similar codes to CPT 17004

Five similar codes to CPT 17004 and how they differentiate are:

1. CPT 17000: Destruction of a single premalignant lesion.
2. +17003: Destruction of each additional premalignant lesion, up to 14 lesions, when billed with CPT 17000.
3. CPT 17110: Destruction of benign lesions other than skin tags or cutaneous vascular proliferative lesions, up to 14 lesions.
4. CPT 17111: Destruction of benign lesions other than skin tags or cutaneous vascular proliferative lesions, 15 or more lesions.
5. CPT 17250: Chemical cauterization of granulation tissue, performed per session.

10. Examples

Here are 10 detailed examples of CPT code 17004 procedures:

1. A patient with 20 actinic keratoses on their face undergoes laser surgery to destroy the lesions.
2. A patient with 15 premalignant lesions on their arms receives cryosurgery for lesion destruction.
3. A provider performs electrosurgery to destroy 17 premalignant lesions on a patient’s back.
4. A patient with 18 actinic keratoses on their chest undergoes chemosurgery for lesion destruction.
5. A provider uses surgical curettement to destroy 15 premalignant lesions on a patient’s legs.
6. A patient with 25 actinic keratoses on their scalp receives laser surgery for lesion destruction.
7. A provider performs cryosurgery to destroy 16 premalignant lesions on a patient’s hands.
8. A patient with 19 actinic keratoses on their neck undergoes electrosurgery for lesion destruction.
9. A provider uses chemosurgery to destroy 15 premalignant lesions on a patient’s shoulders.
10. A patient with 20 actinic keratoses on their abdomen receives surgical curettement for lesion destruction.