Wiki Paring of Wart 17110 or 11055 - ABN?

[heatherwinters]

A patient came in with foot pain and was diagnosed with a plantar wart. The assessment has the plantar wart as one of the dx listed and under plan the clinician wrote "pare wart (done)" He stated that he did indeed pare the wart at this visit.

1) Is "pare wart (done)" along with documentation on the exam of the plantar wart location enough to bill for it's removal
2) would you code it as a 17110 or a 11055 with a 078.12
3) Since subjective portion of note documents pain associated with it, would you also use 729.5?
4) Is an ABN needed or would this be considered statutorily excluded as "routine" foot care?

No other examination abnormalities were noted

Other Dx at the time of the visit were: decreased memory, M. avium, pneumonia, crohn's, non hodgkins lymphoma


Here is my Local LCD
http://www.ngsmedicare.com/NGSMedicare/lcd/L26426_active_lcd.htm

 

[FTessaBartels]

NOT adequate documentation of procedure

I would not consider "pare wart (done)" as adequate documentation for a procedure performed.

Once I had an actual procedure note ... it definitely does NOT sound like 17110. Sounds more like 11055.

But, again, there is not adequate documentation of the procedure in my opinion.

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Additional info received at AAPC local chapter meeting presentation by Podiatrist
Someone else actually asked this question at our local chapter meeting last night, where our presentor was a podiatrist. Her response was that 17110 would ONLY be used if the documentation clearly stated the wart was destroyed. 11055 is the correct code for paring of the tissues; frequently this is done to remove tissue that has built-up in reaction to the viral infection and only after paring this tissue down can the wart itself be clearly identified/diagnosed.

She agreed that "pare wart (done)" does not seem to be adequate documentation of the procedure.
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F Tessa Bartels, CPC, CEMC