ICD-10 Coding for Warts

Warts are a form of lesion most often caused by a viral infection; however, some warts are bacterial, rather than viral. Warts are most common in children, young adults, and people with immune system deficiencies. Clinical categories of warts include:

Common warts (Verruca vulgaris): A raised wart with roughened surface, most common on hands, but can grow anywhere on the body.

Plantar warts (Verruca plantaris): A hard, sometimes painful lump, often with multiple black specks in the center; usually only found on pressure points on the soles of the feet.

Flat warts (Verruca plana): A small, smooth flattened wart, flesh-colored, which can occur in large numbers; most common on the face, neck, hands, wrists and knees. Commonly seen in teenagers.

Venereal warts (Condyloma acuminatum, Verruca acuminata): A wart that occurs on the genitalia.

Tuberculosis warts (Lupus verrucosus, Prosector’s wart, Warty tuberculosis): A rash of small, red papular nodules in the skin that may appear 2-4 weeks after inoculation by Mycobacterium tuberculosis in a previously infected and immunocompetent individual

Code Selection depends on the type of wart:

B07.0 Plantar wart

Verruca plantaris

B07.8 Other viral warts

Common wart

Flat wart

Verruca plana

B07.9 Viral wart, unspecified

A63.0 Anogenital (venereal) warts

A18.4 Tuberculosis of skin and subcutaneous tissue

Example:

CHIEF COMPLAINT: Skin lesion on hand

HISTORY OF PRESENT ILLNESS: Established patient comes in with skin lesions. Onset: 1 week ago. Severity: mild-moderate. Location is hands. The patient describes it as a popular; it occurs constantly. The lesion is unchanged. Context: viral illness; Denies aggravating factors, relieving factors. Pertinent negatives include: burning, discharge from lesion, fever, itching, pain, sores that do not heal, swollen glands, change in shape/size of lesions, change in color of lesions. Additional information: here for lesion/wart removal.

EXAMINATION: VITAL SIGNS: BP 115/74, Temp (F) 98.20, P 66, RR 18, Wt. 144. GENERAL/CONSITIUTIONAL: No apparent distress. Well-nourished well developed. INTEGUMENTARY: The type of lesion is verruca vulgaris. Visual lesion(s) appear on bilateral, hand, number of lesions is 10, flesh in color. The lesion is 1 cm in size.

COMMENTS: 2 large ones primary on right hand; 2 only on left hand; some are periungual.

PROCEDURES: Lesion/Wart Removal x4. Lesion/wart prepped and draped using sterile technique. Removal of 4 warts was performed. Liquid nitrogen was used to remove wart(s). Applied sterile dressing and discussed wound care instructions.

ASSESSMENT/PLAN: Warts Viral NOS. Treatment option and natural history discussed; will Cryo lesion; Compound-W nightly with occlusion until follow-up in a few weeks.

Based on the documentation, the patient is diagnosed with viral warts on the hands. The correct ICD-10-CM code is B07.9 Viral wart, unspecified.

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John Verhovshek

John Verhovshek, MA, CPC, is Managing Editor at AAPC. He has covered medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University, and a member of the Asheville-Hendersonville AAPC Local Chapter.

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