Wiki paring callus with dremel

[Merlin0728]

We have a provider that states she "pares a callus with a dremel tool". Another time she will state she "smooths a callus with a dremel tool".
One definition of paring is removal of outer layer or edge.
We are looking for information on whether you would bill CPT code 11055 for one or both of these situations.
Thank you for any input you may have!

 

[LindaDuckworth]

We have a provider that states she "pares a callus with a dremel tool". Another time she will state she "smooths a callus with a dremel tool".
One definition of paring is removal of outer layer or edge.
We are looking for information on whether you would bill CPT code 11055 for one or both of these situations.
Thank you for any input you may have!

wish there was an answer published. I now have the exact same question.

 

[csperoni]

So outside of my regular coding, but I think this comes down to whether you consider a dremel tool a "surgical instrument."
11055 Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion
The provider removes a single benign hyperkeratotic lesion by using surgical instruments like a scalpel or curette
Clinical Responsibility
When the patient is appropriately prepped and anesthetized, the provider evaluates the size, depth, and location of the benign hyperkeratotic lesion. She uses a scalpel, curette, blade, or a spoon–shaped surgical instrument to trim or pare down the lesion. The provider applies antiseptic to the site and, if necessary, removes the pressure points by fitting padding on the site.

I would be inclined to not consider a dremel a "surgical instrument". The examples given are scalpel, curette, blade, or spoon-shaped surgical instrument.
This thread from 2015 gives the advice that 11055 is not appropriate for sanding a callus and I agree.

 

[podcoder70]

It's simple...
11055-57 is defined as "paring or cutting" a corn or callus, other sources add "removal of" or "curettement" and the service is covered by payers because it is deemed unsafe for a "layperson" to perform this treatment under certain circumstances and systemic conditions. Essentially, it is "debulking" the thick skin. The tool to do this does not matter that much, in my opinion, and the AMA nor APMA does not provide an example of a tool (unlike the 1104x wound debridement codes) that I can find in a fairly extensive search.

For callus paring/cutting (or removal), anesthesia is rarely required with the exception of perhaps a topical lidocaine. When billing/coding this procedure, we are less concerned about the methodology than we are the reason...the supporting systemic condition and proper documentation of said procedure.