Podiatry Coding & Billing Alert

Never report 17110 and 17111 on the same claim.

Don’t let reporting wart removal trip you up. Not only should you be clear about which method the podiatrist used to remove the wart, but you should also understand which CPT^® codes you cannot report together. If you’re not careful, you could be making major errors on your claims.

Answer the follow FAQs to make sure you’re not leaving money on the table when reporting for wart removal.

Check Number of Warts for Correct CPT® Choice

FAQ 1: The podiatrist used laser surgery to remove five warts on a patient’s left foot. Which CPT^® code should we report for this?

Answer 1: You should report 17110 (Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions) for this service.

With both 17110 and 17111 (Destruction [e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement], of benign lesions other than skin tags or cutaneous vascular proliferative lesions; 15 or more lesions), the physician uses destruction to remove the patient’s wart.

With destruction methods, the podiatrist may expose the targeted lesion to laser beam, high frequency electrical current, or chemical agents, or he may withdraw heat from targeted tissue, use liquid nitrogen, or surgically eradicate the lesion.

Notice: If the number of warts the podiatrist removed is 14 or less, then you should submit 17110 with one unit of service. However, if the podiatrist removes 15 or more warts, then you would report 17111 with one unit of service.

Never Report These 2 Codes Together on Same Claim

FAQ 2: Can we ever bill 17110 and 17111 on the same claim?

Answer 2: No. You should never bill both 17110 and 17111 on the same claim or submit either code with more than one unit of service, cautions Arnold Beresh, DPM, CPC, CSFAC, in West Bloomfield, Michigan.

Puzzle Out Type of Skin Biopsy, Number of Lesions

FAQ 3: The podiatrist suspected that the wart-like growth was malignant, so he performed a biopsy. Which CPT^® codes should we look to for this service?

Answer 3: This answer depends on the type of skin biopsy the podiatrist performed and the number of lesions he biopsied. When it comes to skin biopsies, there are three different kinds — tangential, punch, and incisional.

Tangential biopsy: For tangential biopsy codes, you look to codes 11102 (Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); single lesion) and +11103 (… each separate/additional lesion (List separately in addition to code for primary procedure)).

As the code descriptor for 11102/+11103 implies, you can use these codes when your provider takes a sample “along the tangent, or the sample is superficial,” according to Sherika Charles, CDIP, CCS, CPC, CPMA, compliance analyst with UT Southwestern Medical Center in Dallas, Texas.

Punch biopsy: For punch biopsies, you will look to 11104 (Punch biopsy of skin (including simple closure, when performed); single lesion) and +11105 (… each separate/additional lesion (List separately in addition to code for primary procedure)).

In a punch biopsy procedure, “the patient is anaesthetized and pierced typically using a disposable skin biopsy instrument,” Charles explains. The instrument is usually a 2-8 mm pen that can go deep into the subcutaneous layer of layer and remove a full-thickness, cylindrical sample of skin.

Incisional biopsy: Finally, for incisional biopsies, look to 11106 (Incisional biopsy of skin (eg, wedge) (including simple closure, when performed); single lesion) and +11107 (… each separate/additional lesion (List separately in addition to code for primary procedure)).

Incisional biopsies “involve removal of a larger and deeper amount of skin — a full-thickness sample of tissue penetrating deep to the dermis, into the subcutaneous space — which typically requires the use of a scalpel and involves a more complex closure,” according to Charles.

Coding example: The podiatrist performed a tangential biopsy on a single wart-like lesion on the patient’s foot. He employed the shave technique, where he removed a tissue sample by elevating the skin. The podiatrist then used a straight blade to slice the skin to the epidermis level. You would report 11102 for this service.