CPCA Coding for Laser Treatments 5

Question 1

A payer applies the National Correct Coding Initiative (NCCI) edits and denies a claim pairing 17000 with 17110. Why?

Accepted Answer

Modifier 59 is required on 17110 to bypass the edit

Answer

NCCI edits pair 17000 (premalignant lesion) and 17110 (benign lesion) as a column 1/column 2 edit, but modifier 59 (distinct procedural service) on 17110 can override the edit when truly separate lesions of different types are treated.

Question 2

Laser trabeculoplasty for open-angle glaucoma is coded from which CPT code range?

Accepted Answer

65850–65865

Answer

CPT 65855 (Trabeculoplasty by laser surgery) reports laser trabeculoplasty for glaucoma and falls in the 65850–65865 range of ophthalmology procedure codes.

Question 3

Which of the following laser procedures is reported with CPT 67228 (Treatment of extensive or progressive retinopathy)?

Accepted Answer

Scatter laser photocoagulation for diabetic retinopathy

Answer

CPT 67228 reports laser photocoagulation for extensive or progressive diabetic or other retinopathy, commonly referred to as panretinal photocoagulation (PRP).

Question 4

A surgeon performs laser ablation of the endometrium. Which CPT code is reported?

Accepted Answer

58563

Answer

CPT 58563 reports hysteroscopy with endometrial ablation (includes laser ablation), capturing the laser-based destruction of endometrial tissue performed via hysteroscope.

Question 5

When a laser procedure note documents the lesion size before and after treatment, which measurement determines the CPT code selection for skin destruction?

Accepted Answer

Pre-treatment lesion diameter

Answer

CPT guidelines specify that the size of the lesion—measured before excision or destruction—determines code selection; the post-procedure defect may be larger and should not be used.

CPCA Exam Practice Test

CPCA Exam Practice Test

CPCA Coding for Laser Treatments 5