CPCA CPT for Aesthetic Procedures Questions and Answers — Questions and Answers
Question 1: A patient undergoes a cosmetic procedure to treat fine lines on her full face. The physician performs a chemical peel of the epidermal layer. Which CPT® code should be reported for this procedure?
- 15792
- 15789
- 15788 (Correct answer)
- 17360
Correct answer: 15788
CPT® code 15788 specifically describes a chemical peel of the facial, epidermal layer. Code 15789 is for a dermal peel, 15792 is for a nonfacial epidermal peel, and 17360 is for chemical exfoliation for acne, which is less specific and typically used when treating a medical condition rather than for purely cosmetic reasons.
Question 2: A provider injects a soft tissue filler into the patient's nasolabial folds for cosmetic augmentation. The total volume of the filler material injected is 4.5 cc. How should this service be coded?
- 11950
- 11951 (Correct answer)
- 11952
- 11954
Correct answer: 11951
The CPT® codes for subcutaneous injection of filling material are based on the volume injected. Code 11951 is defined as 'Subcutaneous injection of filling material (eg, collagen); 1.1 to 5.0 cc'. Since 4.5 cc falls within this range, 11951 is the correct code. 11950 is for 1.0 cc or less, 11952 is for 5.1 to 10.0 cc, and 11954 is for over 10.0 cc.
Question 3: A patient receives Botox injections to treat glabellar frown lines. The physician performs chemodenervation of the corrugator and procerus muscles. Which CPT® and HCPCS codes should be reported for the procedure and the supply of onabotulinumtoxinA?
- 64615, J0585
- 64612, J0588
- 64999, J0585
- 64612, J0585 (Correct answer)
Correct answer: 64612, J0585
CPT® code 64612 represents 'Chemodenervation of muscle(s) innervated by facial nerve (eg, for blepharospasm, hemifacial spasm)'. This code is appropriate for cosmetic injections targeting facial muscles. HCPCS code J0585 is used to report the supply of onabotulinumtoxinA (Botox®) per unit. Code 64615 is for chemodenervation that includes neck and/or trigeminal nerves and is bilateral, making it incorrect for targeted glabellar injections. J0588 is the code for incobotulinumtoxinA (Xeomin®).
Question 4: A patient requests laser hair removal on her upper lip and chin for cosmetic purposes. Since there is no specific CPT® code for this service, which of the following is the most appropriate code to report?
- 17000
- 96999
- 17999 (Correct answer)
- 17250
Correct answer: 17999
When a specific CPT® code does not exist for a procedure, an unlisted procedure code should be used. For procedures on the skin, CPT® code 17999, 'Unlisted procedure, skin, mucous membrane and subcutaneous tissue', is the correct choice. Laser hair removal performed for cosmetic reasons does not have a dedicated CPT® code. The other codes are incorrect as 17000 is for destruction of premalignant lesions, 96999 is an unlisted special dermatological service, and 17250 is for chemical cauterization of granulation tissue.
Question 5: A 45-year-old patient undergoes full-face ablative laser resurfacing to improve the appearance of wrinkles and sun damage. Which series of CPT® codes, originally for dermabrasion, is commonly reported for this type of aesthetic procedure, depending on payer policy?
- 17110-17111
- 15780-15783 (Correct answer)
- 96920-96922
- 11440-11446
Correct answer: 15780-15783
There are no specific CPT® codes for laser skin resurfacing. However, it is common practice for many payers to accept the dermabrasion codes (15780-15783) for these procedures. CPT® 15780 describes 'Dermabrasion; total face'. The other code ranges are inappropriate: 17110-17111 are for destruction of benign lesions, 96920-96922 are for laser treatment for inflammatory skin disease, and 11440-11446 are for excision of benign lesions from the face.
Question 6: Which of the following common aesthetic procedures lacks a specific CPT® code and is generally not billable to insurance as it is considered a cosmetic service?
- Dermal filler injection, 1.2 cc
- Epidermal chemical peel, non-facial
- Cryolipolysis of the abdomen (Correct answer)
- Chemodenervation for facial wrinkles
Correct answer: Cryolipolysis of the abdomen
Cryolipolysis (e.g., CoolSculpting®) is a non-invasive fat reduction procedure that is considered cosmetic and does not have a specific CPT® code for billing to insurance. The other options have established CPT® codes: Dermal filler injections are coded based on volume (e.g., 11951), chemical peels have specific codes based on location and depth (e.g., 15792), and chemodenervation has a procedure code (e.g., 64612).
CPCA CPT for Aesthetic Procedures Questions and Answers
A patient undergoes a cosmetic procedure to treat fine lines on her full face.
The physician performs a chemical peel of the epidermal layer.
Which CPT® code should be reported for this procedure?