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Cutaneous vascular proliferative lesions are abnormal growths of blood vessels in the skin, which can manifest in various forms, including port wine stains, hemangiomas, and telangiectasias. These lesions often require treatment to reduce their appearance and associated symptoms. The procedure for treating these lesions involves a technique known as selective photothermolysis, which specifically targets the oxyhemoglobin in the blood vessels. This is achieved using specialized laser technology, such as a flash lamp pumped pulsed-dye laser, argon-pumped tunable dye laser, or other types of lasers like copper vapor, copper bromide, or krypton lasers. During the procedure, the laser is calibrated to the appropriate wavelength, pulse duration, and pulse energy to effectively treat the specific lesion type. The laser is then activated to deliver precise energy to the lesion, leading to its destruction. It is important to note that patients may require multiple sessions of laser treatment to achieve optimal results, especially for larger lesions. For coding purposes, CPT® Code 17108 is specifically designated for the destruction of cutaneous vascular proliferative lesions that exceed 50.0 square centimeters in size, while other codes are available for smaller lesions.
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Destruction of cutaneous vascular proliferative lesions is indicated for various conditions that affect the skin's appearance and can cause psychological distress or functional impairment. The following are the explicitly provided indications for this procedure:
The procedure for the destruction of cutaneous vascular proliferative lesions involves several critical steps to ensure effective treatment. Each step is designed to maximize the efficacy of the laser treatment while minimizing discomfort and potential side effects.
Post-procedure care is essential for optimal recovery and results. Patients may experience some redness, swelling, or discomfort in the treated area, which typically resolves within a few days. It is important for patients to follow the aftercare instructions provided by the healthcare provider, which may include avoiding sun exposure, applying prescribed topical treatments, and monitoring for any signs of infection or unusual changes in the treated area. Follow-up appointments may be scheduled to assess the results and determine if additional treatment sessions are necessary to achieve the desired outcome.
| Short Descr | DESTRUCTION OF SKIN LESIONS | Medium Descr | DSTRJ CUTANEOUS VASCULAR LESIONS >50.0 SQ CM | Long Descr | Destruction of cutaneous vascular proliferative lesions (eg, laser technique); over 50.0 sq cm | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Multiple Reduction Applies | ASC Payment Indicator | Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on MPFS nonfacility PE RVUs. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5A - Ambulatory procedures - skin | MUE | 1 | CCS Clinical Classification | 170 - Excision of skin lesion |
| 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | RT | Right side (used to identify procedures performed on the right side of the body) | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | AG | Primary physician | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 1991-01-01 | Added | First appearance in code book in 1991. |
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