Wiki Wart Removal and E&M

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Sandra Fender

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I have an office that wants to charge for the E&M visit as well as the wart removal. My thought is that if they visit is only for the destruction then you can not charge for the 99212. Am I correct in this??? :rolleyes:
 
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Sandra Fender said:
I have an office that wants to charge for the E&M visit as well as the wart removal. My thought is that if they visit is only for the destruction then you can not charge for the 99212. Am I correct in this??? :rolleyes:
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Depends. Did the patient come in for destruction or did the patient come in because of the lesion? Need more information to give a correct answer.
 
If they were already scheduled for the wart removal then the assessment for the necessity of the procedure was already done and it cannot be charged again, therefore procedure only.
 
wart removal and E/M

I don't have a reply but I do have a question, what if the patient was a new patient and got a wart removed as well? Can we bill a new patient and wart rem since they have never been in the office before? and has anyone had it paid? The insurance is Select health Community.
 
When I ran the pediatric practice, wart removal was always an issue since the removal is considered "surgery" and the surgical procedure trumps the e and m since some e and m is involved in the surgical procedure. But, how to get paid for that new patient eval or an established patient for some other CC with a "by the way, can you take off his warts?" and a wart removal. We went to a "surgical" day on the calendar and had the patients come in specifically for "wart removals" and did multiple patients for this. The other key question is to code the correct number of warts removed so you are paid correctly.
 
What if the patient is there for an annual well exam, during the exam they bring up a wart on their toe. Provider looks and gives treatment options and it is decided to freeze the wart. Can the well exam, an office visit, coded to the plantar wart and the lesion removal all be charged?
 
melsuep said:
What if the patient is there for an annual well exam, during the exam they bring up a wart on their toe. Provider looks and gives treatment options and it is decided to freeze the wart. Can the well exam, an office visit, coded to the plantar wart and the lesion removal all be charged?
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I would say depending on the services provided and documentation, it may be appropriate for all to be charged. I would also say it's likely a minimal evaluation above and beyond an annual well exam was done, and an additional E/M with -25 is probably not justified (but it is possible).
Even if all 3 codes are appropriate, many carriers will not pay for all this on the same day and may bundle services depending on your contract and/or their policies.
 
Statement and question: I am new to the billing an coding industry. I understand that a wart removal is ususally billed on it's own without an OV. However, we had a patient come in for a rash (chief complaint) and had a wart removal done. What modifiers would I use to code for an OV and wart removal? TYIA
 
rbonnell said:
Statement and question: I am new to the billing an coding industry. I understand that a wart removal is ususally billed on it's own without an OV. However, we had a patient come in for a rash (chief complaint) and had a wart removal done. What modifiers would I use to code for an OV and wart removal? TYIA
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You can bill both an E/M (based on the rash, only) with a -25 modifier, and the wart removal (17110 or 17111).
 
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