Actinic Growth Removal

I posted a cpt of 99214 with a modifier of 25 and dx code 702.0. My second line of coding was a 17000 and the dx code of 702.0. The first part of the office visit was paid, and the last 17000 was denied, any ideas?

Actinic keratosis destruction

It would be highly unusual to need to bill a 99214 with destruction of an actinic keratosis. CMS and NCCI specifically state that payment for the decision to perform a minor procedure is included in the payment for the procedure itself. It would not be necessary to bill any E/M service, let alone a level four visit.

See this:

http://www.codapedia.com/-article_207_.cfm

and this:

http://www.codapedia.com/-article_206_.cfm

Some LCD's specifically state that derm procedures don't warrant an E/M .

Be careful about always billing an E/M with a procedure. It can increase your chance of an audit.

Actinic Growth Removal

Thanks, very helpful.