May 28, 2020

Question:
We had a Medicare patient who came in with AKs and a lesion on the eyelid. Twenty AKs were destroyed on the patient’s chest and scalp and an incisional biopsy was performed on the lesion on the eyelid, what CPT codes do I use?

Answer:
You will need to report both procedures; CPT 67810 and 17004. CPT code 67810 (Incisional biopsy of eyelid skin) is bundled into 17004 (Destruction of 15 or more premalignant lesions). But since the biopsy was performed on a different anatomical site from the destructions, code 67810 may be reported with modifier 59 to indicate that it was a separate site. This will appropriately bypass the NCCI edits.

*This response is based on the best information available as of 5/28/20.