Wiki hyperkeratotic tissue

[solocoder]

Our clinic policy is we don't do routine foot care. No nail or callus trimming.
So I don't know much about it. Could someone tell me the difference between 11055 and 11305?
The doctor coded it as 11305. Here is the pertinent part of the note I am questioning:

Painful deeply nucleated hyperkeratotic tissue is noted at the distal tip of the left 3rd digit.
The painful area at the distal tip of the left 3rd digit is shaved and protective, accommodative padding is applied.

 

[PLAIDMAN]

Our clinic policy is we don't do routine foot care. No nail or callus trimming.
So I don't know much about it. Could someone tell me the difference between 11055 and 11305?
The doctor coded it as 11305. Here is the pertinent part of the note I am questioning:

Painful deeply nucleated hyperkeratotic tissue is noted at the distal tip of the left 3rd digit.
The painful area at the distal tip of the left 3rd digit is shaved and protective, accommodative padding is applied.

I would not have an issue with using 11305 BUT - you MUST have size of lesion documented - it does not appear your doc has done this ?

It leaves you with no choice but 11055

 

[solocoder]

update

Turns out that was not an isolated case. The same doctor is billing 11305 and 11306 a few times a week now. He is documenting the size of the lesions, as well as the instrument used -scalpel.
Medicare does not cover routine trimming of calluses and my concern is, if an auditor read these notes, they would consider this no different than routine callus trims. And by then, how many hundreds of these would we have billed incorrectly?
Appreciate advice from you podiatry coders out there.