Primary Care Coding Alert

Question: Which code should I use for cryotherapy treatment of a common or plantar wart on the skin   17000 or 17110? Does sending the samples to a pathologist change the coding?

Florida Subscriber  
Answer: Although 17110 (Destruction [e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement], of flat warts, molluscum contagiosum, or milia; up to 14 lesions) has the word warts in the description, it is not the most accurate code to use in this case. In fact, in a parenthetical instruction after 17111, CPT states, For destruction of common or plantar warts, see 17000, 17003, 17004. Accordingly, report 17000 (Destruction [e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement], all benign or premalignant lesions [e.g., actinic keratoses] other than skin tags or cutaneous vascular proliferative lesions; first lesion) for common or plantar wart removal. The destruction of multiple warts may result in greater payment. 
 
Warts are usually removed by destruction as described in codes 17000-17250. The methods of treatment include cryosurgery, laser, chemical treatment and electrosurgery. The physician needs to document the specific type of wart removed, in this case a common or plantar wart, because that determination may affect reimbursement. Sending the samples to a pathologist does not change the coding.