Forum - Questions & Answers

Jan 6th, 2010 - j.berkshire 7 

ABN and acne treatment

I've searched CMS's site for LCD/NCD information for acne treatment, CPT 10040, and can find no information. I also see that this CPT code is active in the physician fee schedule. Do I need to provide an ABN for Medicare patients undergoing this type of treatment?

Jan 6th, 2010 - nmaguire   2,606 

Abn

I would provide an ABN, just in case.
CPT code 10040- Acne surgery (e.g., marsupialization, opening or removal of multiple milia, comedones, cysts, pustules) is not a covered benefit for most payers. It is an active code for Medicare but diagnosis will establish payment or not.
Possible diagnosis: 680.0 Carbuncle and furuncle of face; 686.00 Pyoderma, unspecified; 686.01 Pyoderma gangrenosum of skin and subcutaneous tissue; 686.09 Other pyoderma of skin and subcutaneous tissue; 695.3 Rosacea; 704.8 Other specified diseases of hair and hair follicles; 706.0 Acne varioliformis; 706.1 Other acne; 706.2 Sebaceous cyst; 706.8 Other specified diseases of sebaceous glands; 709.3 Degenerative skin disorders.



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