ED Coding and Reimbursement Alert

READER QUESTIONS :

Disregard Generic Code for Plantar Wart

Question: A patient reports to the ED with a painful right foot. The ED physician finds a pair of plantar warts, which he removes using a scalpel. I reported 17110 with 078.19 appended, and received a denial. Did I choose the wrong procedure code? Oregon Subscriber Answer: No, you chose the wrong diagnosis code. Re-submit the claim using 17110 (Destruction [e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement], of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions) for the wart removals, and 078.12 (Plantar wart) to represent the warts. Explanation: Before 2009, 078.19 (Other specified viral warts) was the proper diagnosis code for plantar warts. This year saw the debut of 078.12, however, giving coders and physicians a more appropriate (and specific) code for this very common condition. -- Reader Questions and You Be the Coder reviewed by Michael A. Granovsky, MD, CPC, FACEP, [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.