Podiatry Coding & Billing Alert

Podiatry Coding:

Code This Hyperkeratotic Lesion Removal Case

Question: A podiatrist saw a Medicare patient with diabetes and evaluated the patient’s feet. The patient was educated about proper diabetic foot care, and the provider recommended the patient check their feet daily for any changes. The physician then used a #15 blade to perform aseptic debridement of two hyperkeratotic lesions on the left calf without complications.

What CPT® code should I assign for the debridement?

New York Subscriber

Answer: Assign 11056 (Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); 2 to 4 lesions) to report the removal of the two hyperkeratotic lesions. Some coders might argue for 11042 (Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less) based on the use of the term “debridement” in the procedure note. However, 11042 is typically used for debridement of ulcers and open wounds down to and including subcutaneous tissue.

Mike Shaughnessy, BA, CPC, Production Editor, AAPC