Wart Destruction and Shave Biopsy

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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elenax

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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!
 

cinnee

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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
 

DocAssist

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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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