Wiki Wart Destruction and Shave Biopsy

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cinnee

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My doctor treated a patient for warts and documented "Excision & Cauterization X 4 lesions". She coded a destruction code of 17110 and a shave biopsy code of 11301. She used 238.2 as the diagnosis on the path report and 078.10 for the destruction of the warts. The 11301 would require a modifier 59 to bypass the edits, but since the the biopsy is being done on the same site, I can't really justify using this modifier. Are both of these codes payable on the same day?

Cindy Gratton, CPC
 
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Per the CCI the 17110 and the 11301 are not bundled. I would code both if the documentation supports that the procedures were "different" even though are on the same site and I mean 'detail documentation between both procedures'.

I hope this helps!
 
Thanks for your response. The documentation does support both procedures; however, according the the Inga Ellzey Derm Coder program I use, the modifier 59 is required on the 11301 so this is why I'm somewhat confused.

Cindy
 
Your Inga Ellzey course is correct in that 11301 does require modifier 59 as it is mutually exclusive of 17110. This is verified on the CMS CCI edit website.
 
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