Podiatry Coding & Billing Alert

Question: My podiatrist removed 16 warts from the patient’s right foot in one visit. Would I bill this as 17110 and add 17111? Are those allowed to be billed together?

South Dakota Subscriber

Answer: You should not bill 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) and 17111 (… 15 or more lesions) on the same claim or submit either code with more than one unit of service. Because 17111 covers 15 lesions or more, and the podiatrist removed 16 warts, you would not need to add any additional codes to your claim. You should never use 17110 and 17111 together. Instead, you would choose one or the other based on how many lesions were removed. If more than 14 lesions are removed in one visit, you would use 17111 one time as this code does not have a maximum number of lesions listed.

Additional info: If you check the National Correct Coding Initiative (NCCI) edits, you will see a procedure-to-procedure (PTP) edit between codes 17110 and 17111. Code 17110 is a Column 2 code for 17111, which means they are bundled together. Since the modifier indicator for this edit is “0,” you can never break the edit with a modifier.