Dermatology Coding Alert

Published on Thu Aug 13, 2015 PDF

Question: An established patient requested skin tag removal during another service. The dermatologist chemically burned off the tag.How should I report this?

New Jersey Subscriber

Answer: The insurer will probably not cover the destruction — and approximately $88 is at stake.

Best bet: Crank out your private payer version of an advance beneficiary notice (ABN), or have a cash policy. Often insurers will consider skin tag removal cosmetic and won’t cover the procedure.

When it comes to assigning a number, skin tag removal including destruction puts you back into the 11000 skin series, rather than the 17000 destruction family. The CPT^® skin tag numbering system works this way.

• For removal up to and including 15 skin tags, use CPT^® code 11200 (Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions), which has 2.49 RVUs or pays approximately $89.47.

• For each additional set of 10 lesions, or part thereof, report +11201 (… each additional 10 lesions, or part thereof [List separately in addition to code for primary procedure]) (0.53 RVUs).

Don’t miss: Link 701.9 (Unspecified hypertrophic and atrophic conditions of skin) to 11200.