How To Use CPT Code 96921

CPT 96921 describes the use of an ultraviolet B (UVB) laser to treat severe inflammatory skin diseases, such as psoriasis, on a treatment area between 250 cm2 to 500 cm2. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 96921?

CPT 96921 is used to describe the use of an ultraviolet B (UVB) laser for the treatment of severe inflammatory skin diseases, specifically on a treatment area between 250 cm2 to 500 cm2. This code is used when a healthcare provider applies mineral oil over the treatment area and exposes it to UVB light at a wavelength of 308 nm using an excimer laser. The light is delivered in short bursts, sweeping back and forth over the treatment area.

2. Official Description

The official description of CPT code 96921 is: ‘Laser treatment for inflammatory skin disease (psoriasis); 250 sq cm to 500 sq cm.’

3. Procedure

1. The healthcare provider explains the potential risks and benefits of the treatment to the patient.
2. Mineral oil is applied over the treatment area to enhance the penetration of UVB light and minimize scattering of the light rays.
3. The healthcare provider uses an excimer laser to deliver UVB light at a wavelength of 308 nm to the treatment area.
4. The light is delivered in short bursts, sweeping back and forth over the treatment area.

4. Qualifying circumstances

CPT 96921 is used for patients with severe inflammatory skin diseases, such as psoriasis, that require treatment with an ultraviolet B (UVB) laser. The treatment area must be between 250 cm2 to 500 cm2. The healthcare provider must explain the potential risks and benefits of the treatment to the patient before proceeding.

5. When to use CPT code 96921

CPT code 96921 should be used when a healthcare provider performs laser treatment using an ultraviolet B (UVB) laser on a treatment area between 250 cm2 to 500 cm2 for a patient with severe inflammatory skin diseases, such as psoriasis. This code should not be used for treatment areas less than 250 cm2 or greater than 500 cm2.

6. Documentation requirements

To support a claim for CPT 96921, the healthcare provider must document the following information:

• Patient’s diagnosis of severe inflammatory skin disease
• Size of the treatment area (between 250 cm2 to 500 cm2)
• Explanation of the potential risks and benefits of the treatment
• Application of mineral oil over the treatment area
• Delivery of UVB light at a wavelength of 308 nm using an excimer laser
• Duration and technique of light delivery

7. Billing guidelines

When billing for CPT 96921, ensure that the treatment area falls within the range of 250 cm2 to 500 cm2. The healthcare provider should explain the potential risks and benefits of the treatment to the patient. It is important to note that CPT code 96921 should not be reported with other codes for treatment areas less than 250 cm2 or greater than 500 cm2. Additional tips for reporting CPT code 96921 can be found in the official documentation.

8. Historical information

CPT code 96921 was added to the Current Procedural Terminology system on January 1, 2003. There have been no updates to the code since its addition.

9. Examples

1. A dermatologist using an excimer laser to treat severe psoriasis on a treatment area of 300 cm2.
2. A healthcare provider performing laser treatment for an inflammatory skin disease on a treatment area of 400 cm2.
3. A patient with severe inflammatory skin disease receiving UVB laser treatment on a treatment area of 450 cm2.
4. A dermatologist using an excimer laser to treat psoriasis on a treatment area of 275 cm2.
5. A healthcare provider performing laser treatment for an inflammatory skin disease on a treatment area of 475 cm2.
6. A patient with severe inflammatory skin disease receiving UVB laser treatment on a treatment area of 350 cm2.
7. A dermatologist using an excimer laser to treat psoriasis on a treatment area of 425 cm2.
8. A healthcare provider performing laser treatment for an inflammatory skin disease on a treatment area of 275 cm2.
9. A patient with severe inflammatory skin disease receiving UVB laser treatment on a treatment area of 475 cm2.
10. A dermatologist using an excimer laser to treat psoriasis on a treatment area of 325 cm2.