inflamed acrochordon

pegjoh5746

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I was hoping to get another opinion. My physician did cryosurgery of an imflamed acrochordon. I coded this as 11200 with diagnosis 701.9. However our in house auditor is stating that inflamed acrochordon is not a skin tag and should not be coded as skin tag removal.

If you have any reference material on this issue it would be a great help.
 
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Charlottesville, Va
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An acrocordon is a skin tag (701.9 per the ICD 9-CM) and the 11200 is the only code you are supposed to use for a skin tag. Not only that but the 11200 code is the removal of acrochordons (skin tags) by any method, gradle, cryo, or hyperficator. It doesn't make a difference whether it is inflamed or not to what procedure code or ICD 9 code you use for skin tags, the difference is that some insurances won't cover the removal of skin tags unless the documentation mentions they are inflamed, frequent bleed, or get irritated by clothing such as bras.

I think they may be thinking of an inflamed seborrheic keratosis which is 702.11 and insurance will cover their removal (CPT 17110) but not a regular seborrheic keratosis (702.19)

Hope this helps
Amber
coder for a dermatology practice
 

jholt12

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Hi,
Usually Medicare requires a secondary dx code for 701.9, kind of a descriptive code.
Out of curiosity, what dx code does she say it should be?
 

peachygirl

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Agree with above, Medicare requires secondary dx V49.89 as of 2010 (as long as the note states itchy, inflammed, painful, bleeding--stating "irritated" is not sufficient).
See LCD L10106 for more info http://www.cms.gov/medicare-coverage-database/details/lcd-details.aspx?LCDId=10106&ContrId=35&ver=37&ContrVer=1&CntrctrSelected=35*1&Cntrctr=35&name=Noridian+Administrative+Services,+LLC+(00821,+Carrier)&CntrctrType=Carrier&s=1&bc=BBAAAAIAAAAA&


Not sure if you need this, but it is helpful for benign lesion removals with Medicare.

-Mallory, CPC, CPCD
 

pegjoh5746

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Had a meeting with the auditor she did additional research and decided that I was correct that acrochrodons were skin tags and 11200 was the correct cpt.:):):) Thanks for the additional info about the second diagnosis code needed, was a big help.
 
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