How To Use CPT Code 96933

CPT 96933 describes the use of reflectance confocal microscopy (RCM) for cellular and sub-cellular imaging of the skin, specifically for the interpretation and reporting of findings for a single lesion. 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 96933?

CPT 96933 can be used to describe the use of reflectance confocal microscopy (RCM) for cellular and sub-cellular imaging of the skin. This code specifically applies to the interpretation and reporting of findings for a single lesion. Reflectance confocal microscopy involves focusing near-infrared light on the skin to detect any abnormal lesions or scar formation. The light source connects to a computer that displays the image of the tissue under examination. The provider examines the cellular and subcellular layers of the skin with an imaging device to detect abnormalities in the vasculature of the skin. The provider then interprets the result and reports the findings.

2. Official Description

The official description of CPT code 96933 is: ‘Reflectance confocal microscopy (RCM) for cellular and sub-cellular imaging of skin; interpretation and report only, first lesion.’

3. Procedure

1. The provider uses a special microscope to examine a single lesion on the skin by focusing near-infrared light through a laser diode on the target skin.
2. The near-infrared light reflects back from the skin tissue in different proportions.
3. The diode connects to a computer that captures and displays the images of the skin tissue under examination.
4. The provider interprets the result and reports the findings based on the images captured.

4. Qualifying circumstances

CPT 96933 is used when the provider examines a single lesion on the skin using reflectance confocal microscopy (RCM) for cellular and sub-cellular imaging. This code applies to the interpretation and reporting of findings for the first lesion. It is important to note that this code is specific to the examination of a single lesion and does not cover additional lesions or image acquisition only.

5. When to use CPT code 96933

CPT code 96933 should be used when the provider performs reflectance confocal microscopy (RCM) for cellular and sub-cellular imaging of the skin and provides interpretation and reporting of findings for a single lesion. This code should not be used for image acquisition only or for additional lesions.

6. Documentation requirements

To support a claim for CPT 96933, the provider must document the following information:

• Description of the lesion examined
• Date of the procedure
• Interpretation of the findings
• Report of any abnormalities or relevant observations
• Signature of the provider

7. Billing guidelines

When billing for CPT 96933, ensure that the provider performs reflectance confocal microscopy (RCM) for cellular and sub-cellular imaging of the skin and provides interpretation and reporting of findings for a single lesion. This code should not be reported with other codes for additional lesions or image acquisition only. It is important to follow the specific guidelines and tips provided by the payer to ensure accurate and appropriate billing.

8. Historical information

CPT 96933 was added to the Current Procedural Terminology system on January 1, 2016. There have been no updates to the code since its addition.

9. Examples

1. A dermatologist performs reflectance confocal microscopy (RCM) on a patient’s skin lesion and provides interpretation and reporting of findings.
2. A plastic surgeon uses reflectance confocal microscopy (RCM) to examine a scar formation on a patient’s skin and reports the findings.
3. An oncologist utilizes reflectance confocal microscopy (RCM) to assess a suspicious skin lesion and provides interpretation and reporting of the results.
4. A dermatopathologist examines a skin lesion using reflectance confocal microscopy (RCM) and provides a detailed report on the cellular and sub-cellular imaging findings.
5. A dermatologist performs reflectance confocal microscopy (RCM) on a patient’s skin lesion and reports any abnormalities or relevant observations.
6. A plastic surgeon uses reflectance confocal microscopy (RCM) to examine a lesion on a patient’s skin and provides an interpretation of the findings.
7. An oncologist utilizes reflectance confocal microscopy (RCM) to assess a skin lesion and reports the results to the patient.
8. A dermatopathologist examines a skin lesion using reflectance confocal microscopy (RCM) and provides a comprehensive report on the imaging findings.
9. A dermatologist performs reflectance confocal microscopy (RCM) on a patient’s skin lesion and documents the interpretation and reporting of the findings.
10. A plastic surgeon uses reflectance confocal microscopy (RCM) to examine a scar formation on a patient’s skin and reports any abnormalities or relevant observations.