CPCA Coding for Laser Treatments 3

Question 1

Which ICD-10-CM code category is most commonly linked to laser treatment for actinic keratosis to support medical necessity?

Accepted Answer

L57.0

Answer

ICD-10-CM code L57.0 (Actinic keratosis) is the primary diagnosis code used to establish medical necessity for laser destruction of premalignant sun-damaged skin lesions.

Question 2

Photodynamic therapy (PDT) using a photosensitizing agent applied to the skin is reported with which CPT code?

Accepted Answer

96567

Answer

CPT 96567 reports photodynamic therapy by external application of light to destroy lesions of the skin and adjacent mucosa, which requires a separately reported photosensitizer.

Question 3

A surgeon performs laser ablation of condylomata acuminata in an ASC. Which CPT code best describes this service?

Accepted Answer

46900

Answer

CPT 46900 reports destruction of lesions of the anus (condylomata, papillomata, molluscum, or other benign tumors) by simple means, including laser.

Question 4

When billing laser treatments in an ASC setting, which revenue code is typically used on a UB-04 for surgical laser procedures?

Accepted Answer

0360

Answer

Revenue code 0360 (Operating Room Services) is typically used for surgical laser procedures performed in an ambulatory surgery center or hospital outpatient setting.

Question 5

A patient undergoes laser resurfacing of the full face for scarring. The physician separately reports Modifier 22 on the claim. What does this indicate?

Accepted Answer

Unusual procedural complexity requiring extra work

Answer

Modifier 22 indicates that the service provided was substantially greater than typically required, justifying additional reimbursement beyond the standard fee.

CPCA Exam Practice Test

CPCA Exam Practice Test

CPCA Coding for Laser Treatments 3