Author Topic: Medicare and procedure code 17110  (Read 11284 times)

Meli

  • Full Member
  • ***
  • Posts: 144
  • Melissa Turner
    • Mainstream Services Inc.
Medicare and procedure code 17110
« on: December 29, 2010, 02:58:49 PM »
OB/GYN perfoms procedure 17110 as outpatient.  We submitting claims a notice is received stating the diag 078.19 has to be accompanied by another diagnosis for Medicare. Can anyone shed a little light on this?  Only 078.19 is provided so I want to be sure I give all the information I can with requesting an additional diag code if its really needed.
Melissa Turner, CPMB
Mainstream Services Inc.
www.msmbinc.com

Michele

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4770
    • Solutions Medical Billing
Re: Medicare and procedure code 17110
« Reply #1 on: December 30, 2010, 08:10:49 AM »
I believe it is because the 078.19 is an 'unspecified' code.  You could call Medicare to verify that, but I think they require a more detailed dx for that procedure.

Michele
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com

oneround

  • Full Member
  • ***
  • Posts: 227
Re: Medicare and procedure code 17110
« Reply #2 on: December 30, 2010, 02:03:10 PM »
17110 DESTRUCTION (EG, LASER SURGERY,
ELECTROSURGERY, CRYOSURGERY,
CHEMOSURGERY, SURGICAL CURETTEMENT),
OF BENIGN LESIONS OTHER THAN SKIN TAGS
OR CUTANEOUS VASCULAR PROLIFERATIVE
LESIONS; UP TO 14 LESIONS

ICD-9 Codes that Support Medical Necessity
It is the responsibility of the provider to code to the highest level specified in the ICD-9-CM (e.g., to the
fourth or fifth digit). The correct use of an ICD-9-CM code does not assure coverage of a service. The service
must be reasonable and necessary in the specific case and must meet the criteria specified in this
determination.
The ICD-9-CM codes listed below identify the lesion being treated and will, by themselves, be
considered for payment:
078.0 MOLLUSCUM CONTAGIOSUM

]235.1 NEOPLASM OF UNCERTAIN BEHAVIOR OF
LIP ORAL CAVITY AND PHARYNX
236.3 NEOPLASM OF UNCERTAIN BEHAVIOR OF
OTHER AND UNSPECIFIED FEMALE GENITAL
ORGANS
236.6 NEOPLASM OF UNCERTAIN BEHAVIOR OF
OTHER AND UNSPECIFIED MALE GENITAL
ORGANS
238.2 NEOPLASM OF UNCERTAIN BEHAVIOR OF
SKIN
239.2 NEOPLASM OF UNSPECIFIED NATURE OF
BONE SOFT TISSUE AND SKIN
374.84 CYSTS OF EYELIDS
686.1 PYOGENIC GRANULOMA OF SKIN AND
SUBCUTANEOUS TISSUE
702.0 ACTINIC KERATOSIS
702.11 INFLAMED SEBORRHEIC KERATOSIS



For the conditions below, a Primary ICD-9-CM code AND a Secondary ICD-9-CM code that
represents a complication are required:
Primary Diagnoses:
078.10 VIRAL WARTS UNSPECIFIED
078.19 OTHER SPECIFIED VIRAL WARTS
210.0 BENIGN NEOPLASM OF LIP
210.4 BENIGN NEOPLASM OF OTHER AND
UNSPECIFIED PARTS OF MOUTH
214.0 LIPOMA OF SKIN AND SUBCUTANEOUS TISSUE
OF FACE
214.1 LIPOMA OF OTHER SKIN AND SUBCUTANEOUS
TISSUE
216.0 BENIGN NEOPLASM OF SKIN OF LIP
216.1 BENIGN NEOPLASM OF EYELID INCLUDING
CANTHUS
216.2
BENIGN NEOPLASM OF EAR AND EXTERNAL
AUDITORY CANAL
216.3 BENIGN NEOPLASM OF SKIN OF OTHER AND
UNSPECIFIED PARTS OF FACE
216.4 BENIGN NEOPLASM OF SCALP AND SKIN OF
NECK
216.5 BENIGN NEOPLASM OF SKIN OF TRUNK EXCEPT
SCROTUM
216.6 BENIGN NEOPLASM OF SKIN OF UPPER LIMB
INCLUDING SHOULDER
216.7 BENIGN NEOPLASM OF SKIN OF LOWER LIMB
INCLUDING HIP
216.8 BENIGN NEOPLASM OF OTHER SPECIFIED SITES
OF SKIN
216.9 BENIGN NEOPLASM OF SKIN SITE UNSPECIFIED
221.1 BENIGN NEOPLASM OF VAGINA
221.2 BENIGN NEOPLASM OF VULVA
222.1 BENIGN NEOPLASM OF PENIS
222.4 BENIGN NEOPLASM OF SCROTUM
228.01 HEMANGIOMA OF SKIN AND SUBCUTANEOUS
TISSUE
237.71 NEUROFIBROMATOSIS TYPE 1 VON
RECKLINGHAUSEN'S DISEASE
274.81 GOUTY TOPHI OF EAR
274.82 GOUTY TOPHI OF OTHER SITES EXCEPT EAR
373.2 CHALAZION
374.51 XANTHELASMA OF EYELID
455.9 RESIDUAL HEMORRHOIDAL SKIN TAGS
528.4 CYSTS OF ORAL SOFT TISSUES
528.6 LEUKOPLAKIA OF ORAL MUCOSA INCLUDING
TONGUE
528.8 ORAL SUBMUCOSAL FIBROSIS INCLUDING OF
TONGUE
616.2 CYST OF BARTHOLIN'S GLAND
624.01 VULVAR INTRAEPITHELIAL NEOPLASIA I [VIN I]
624.02 VULVAR INTRAEPITHELIA LNEOPLASIA II [VIN II]
624.6 POLYP OF LABIA AND VULVA
701.4 KELOID SCAR
701.5 OTHER ABNORMAL GRANULATION TISSUE
701.8 OTHER SPECIFIED HYPERTROPHIC AND
ATROPHIC CONDITIONS OF SKIN
701.9 UNSPECIFIED HYPERTROPHIC AND ATROPHIC
CONDITIONS OF SKIN
702.19 OTHER SEBORRHEIC KERATOSIS
702.8 OTHER SPECIFIED DERMATOSES
706.2 SEBACEOUS CYST
709.2 SCAR CONDITIONS AND FIBROSIS OF SKIN
709.3 DEGENERATIVE SKIN DISORDERS
709.4 FOREIGN BODY GRANULOMA OF SKIN AND
SUBCUTANEOUS TISSUE
727.40 SYNOVIAL CYST UNSPECIFIED
744.1 ACCESSORY AURICLE
744.47 PREAURICULAR CYST
757.32 VASCULAR HAMARTOMAS
757.33 CONGENITAL PIGMENTARY ANOMALIES OF SKIN
757.39 OTHER SPECIFIED CONGENITAL ANOMALIES OF
SKIN
782.2 LOCALIZED SUPERFICIAL SWELLING MASS OR
LUMP
Secondary Diagnoses:
279.00 HYPOGAMMAGLOBULINEMIA UNSPECIFIED
279.01 SELECTIVE IGA IMMUNODEFICIENCY
279.02 SELECTIVE IGM IMMUNODEFICIENCY
279.03 OTHER SELECTIVE IMMUNOGLOBULIN DEFICIENCIES
279.04 CONGENITAL HYPOGAMMAGLOBULINEMIA
279.05 IMMUNODEFICIENCY WITH INCREASED IGM
279.06 COMMON VARIABLE IMMUNODEFICIENCY
279.09 OTHER DEFICIENCY OF HUMORAL IMMUNITY
368.40 VISUAL FIELD DEFECT UNSPECIFIED
368.44 OTHER LOCALIZED VISUAL FIELD DEFECT
368.8 OTHER SPECIFIED VISUAL DISTURBANCES
368.9 UNSPECIFIED VISUAL DISTURBANCE
369.8 UNQUALIFIED VISUAL LOSS ONE EYE
372.10 CHRONIC CONJUNCTIVITIS UNSPECIFIED
372.11 SIMPLE CHRONIC CONJUNCTIVITIS
372.12 CHRONIC FOLLICULAR CONJUNCTIVITIS
372.30 CONJUNCTIVITIS UNSPECIFIED
374.81 HEMORRHAGE OF EYELID
459.0 HEMORRHAGE UNSPECIFIED
682.0 CELLULITIS AND ABSCESS OF FACE
682.1 CELLULITIS AND ABSCESS OF NECK
682.2 CELLULITIS AND ABSCESS OF TRUNK
682.3 CELLULITIS AND ABSCESS OF UPPER ARM AND
FOREARM
682.4 CELLULITIS AND ABSCESS OF HAND EXCEPT FINGERS
AND THUMB
682.5 CELLULITIS AND ABSCESS OF BUTTOCK
682.6 CELLULITIS AND ABSCESS OF LEG EXCEPT FOOT
682.7 CELLULITIS AND ABSCESS OF FOOT EXCEPT TOES
682.8 CELLULITIS AND ABSCESS OF OTHER SPECIFIED SITES
682.9 CELLULITIS AND ABSCESS OF UNSPECIFIED SITES
686.8 OTHER SPECIFIED LOCAL INFECTIONS OF SKIN AND
SUBCUTANEOUS TISSUE
686.9 UNSPECIFIED LOCAL INFECTION OF SKIN AND
SUBCUTANEOUS TISSUE
692.9 CONTACT DERMATITIS AND OTHER ECZEMA
UNSPECIFIED CAUSE
695.89 OTHER SPECIFIED ERYTHEMATOUS CONDITIONS
695.9 UNSPECIFIED ERYTHEMATOUS CONDITION
698.9 UNSPECIFIED PRURITIC DISORDER
708.9 UNSPECIFIED URTICARIA
729.5 PAIN IN LIMB
782.0 DISTURBANCE OF SKIN SENSATION
959.8 OTHER AND UNSPECIFIED INJURY TO OTHER
SPECIFIED SITES INCLUDING MULTIPLE
V10.82 PERSONAL HISTORY OF MALIGNANT MELANOMA OF
SKIN
V10.83 PERSONAL HISTORY OF OTHER MALIGNANT
NEOPLASM OF SKIN
Diagnoses that Support Medical Necessity
Not applicable
ICD-9 Codes that DO NOT Support Medical Necessity
Not applicable
ICD-9 Codes that DO NOT Support Medical Necessity Asterisk Explanation
Diagnoses that DO NOT Support Medical Necessity
Not applicable
General Information
Documentation Requirements
The patient's medical record must contain documentation that fully supports the medical necessity for services
included within this LCD. (See "Indications and Limitations of Coverage.") This documentation includes, but
is not limited to, relevant medical history, physical examination, and results of pertinent diagnostic tests or
procedures.
Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare

DMK

  • Hero Member
  • *****
  • Posts: 680
Re: Medicare and procedure code 17110
« Reply #3 on: December 31, 2010, 12:15:18 PM »
My goodness Michael!  You are the man!!!

oneround

  • Full Member
  • ***
  • Posts: 227
Re: Medicare and procedure code 17110
« Reply #4 on: December 31, 2010, 12:17:21 PM »
LOL, I wish.  I'm just very fond of the LCD's/NCD's.  They pretty much seal the deals for ya.
Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare

tlewis

  • Newbie
  • *
  • Posts: 40
Re: Medicare and procedure code 17110
« Reply #5 on: January 20, 2011, 06:05:36 PM »
Did you send it to path? path reports will usually have a more descriptive (and more accurate) DX then the phys. ie doc sends in 238.2 because it is a mass but path report states it is malignant. I always code off the path because if it is malignant in certain cases I have to file a report with the state.

PMRNC

  • Hero Member
  • *****
  • Posts: 4254
    • One Stop Resources & Networking for Medical Billers
Re: Medicare and procedure code 17110
« Reply #6 on: January 20, 2011, 08:42:06 PM »
Quote
Did you send it to path? path reports will usually have a more descriptive (and more accurate) DX then the phys. ie doc sends in 238.2 because it is a mass but path report states it is malignant. I always code off the path because if it is malignant in certain cases I have to file a report with the state.

EXCELLENT point and ONE of the reasons I do not respond or answer specific coding questions.   
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Meli

  • Full Member
  • ***
  • Posts: 144
  • Melissa Turner
    • Mainstream Services Inc.
Re: Medicare and procedure code 17110
« Reply #7 on: January 21, 2011, 07:43:29 PM »
Thanks for the feedback.  I am not a coder but I want to be sure the information provided to me is correct or at least provide some direction on why I am sending the charge back for more information other than because the insurance company said so.   ;)  This was sent back to the provider for additional information. 
Melissa Turner, CPMB
Mainstream Services Inc.
www.msmbinc.com