CPT Code 96574: Photodynamic Therapy for Actinic Keratosis, Face/Scalp

The American Medical Association (AMA) outlines in the revised Current Procedural Terminology that activation of a photosensitizing drug—such as aminolevulinic acid—occurs through the external application of light. This illumination must be part of a complete application and illumination activation cycle, which is directly involved in targeting and destroying premalignant hyperkeratotic lesions.

Yes, PDT treatment can be paired with targeted curettage, particularly when treating cutaneous lesions that are thickened or scaly, such as premalignant hyperkeratotic lesions. However, both services must be medically necessary, and if separately reportable, must be performed on distinct lesions or anatomical areas. The qualified healthcare professional must clearly document that curettage and photodynamic therapy were provided as separate and distinct services to ensure accurate billing.

While documentation of the entire tube isn’t always required, it is essential to specify the dose applied, site of application, and the illumination activation method used. The therapeutic approach must be documented in detail, especially when multiple lesions of the skin or adjacent mucosa are treated. The vast majority of payer policies also require clear notation that a qualified healthcare professional performed or directly supervised the application and illumination activation steps.