Ensuring Accurate Reporting of Treatment or Removal of Warts

Ensuring Accurate Reporting of Treatment or Removal of Warts

Submitting accurate claims for wart removal requires careful scrutiny of the documentation to determine the type and number of warts, and other factors.

Outsource Strategies International 8596 E. 101st Street, Suite H Tulsa, OK 74133

Medical billing outsourcing companies help dermatologists submit accurate claims for all the procedures and services they provide. A common condition, warts are small, benign growths caused the human papillomavirus (HPV). Coding and billing for wart treatment or removal requires careful scrutiny of the physician’s documentation to determine the type of wart, exact wart removal method, and number of warts removed.

Warts appear as small lumps on the skin of the hands and feet. There are different types of warts. They can occasionally itch or bleed, though only some types are painful. Warts have an irregular surface and appear in different shapes such as round and oval. They can be firm and raised and vary in size, from less than 1mm to more than 10mm (1cm) in diameter. Warts are diagnosed using the following methods: - Examination of the wart - Scraping off the top layer of the growth to check for clotted blood vessels, a common symptom of the condition - Performing a shave biopsy (removing a section of the wart) and conducting a lab test to rule out skin conditions and diseases

Treatment and/or removal of warts include one or more of the following procedures: o Cryotherapy (super-freezing tissue) o Electrosurgery - burning the skin via an electrical charge o Excision or surgical curettage - surgical removal (scraping or cutting) of wart tissue using a scalpel or a small, sharp, spoon-shaped tool o Shave excision – using a sharp razor to remove the growth o Biopsy – removal of tissue for examination under a microscope www.outsourcestrategies.com

918-221-7769

o Intralesional injection therapy or topical immunotherapy o Laser therapy – using laser light to burn and destroy the wart tissue o Chemosurgery - using cauterets

The aim of all wart treatments is to irritate the skin and prompt the body's own infection-fighting cells to remove the warts. However, the HPV virus that causes warts stays in the body even after wart treatment, and so the warts can come back, according to the U.S. National Library of Medicine.

Both primary care physicians and dermatologists perform wart removal. Medicare and many health insurance companies cover wart removal. Coverage is based on medical necessity. If the wart treatment is largely cosmetic, payers may not cover it. Providers need to have a clear idea about payer coverage rules to get reimbursed for wart removal. The CPT code ranges for treatment or removal of warts are as follows:

11300-11313: Shaving of epidermal or dermal lesions 11400-11446: Excision, benign lesions 17000-17004: Destruction, (such as laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (such as actinic keratoses) 17110-17111, 17250: Destruction, (such as laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular lesions

In 2019, six new skin biopsy codes have been introduced (11102-11107) to differentiate between tangential, punch and incisional skin biopsies. Points to note: www.outsourcestrategies.com

918-221-7769

o A tangential biopsy involves a shave, scoop, saucerize or curette type of biopsy and does not involve removal of lesion, the new codes should not be confused with the shaving of lesion� codes, 11300-11313. o CPT 11300-1313 are limited to use for skin only and are appropriate when a portion of an entire cutaneous lesion is tangentially removed with a sharp blade, with the depth of the removal extending no deeper than into the dermis. o CPT distinguishes a simple excision (codes 11400-11646) from a biopsy or shave via 2 criteria: - the excised lesion must be removed through the dermis - the excision includes margins o If a combination of different types of skin biopsies is performed, the highest code in the hierarchy is reported for the primary code and the add-on code for the second biopsy.

To ensure correct wart removal claim billing and reimbursement, medical coders should examine the physician’s documentation carefully to:  Determine the wart removal method and number of warts removed: For removal of 14 or less warts, use 17110 (Destruction [e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement], of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions) and one unit of service. For removal of 15 or more warts, bill CPT 17111 (Destruction [e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement], of benign lesions other than skin tags or cutaneous vascular proliferative lesions; 15 or more lesions) with one unit of service. www.outsourcestrategies.com

918-221-7769

 Determine the correct type of wart removed: It should be determined if the wart is a common wart, a plantar wart or a flat wart. CPT codes 17110 and 17111 should be used for flat warts and molluscum contagiosum destruction, and 17000 and 17003 are appropriate to report plantar wart removal. It is also important to check if the growth is documented as benign, premalignant, or malignant. Codes from the 11400 series (Excision, benign lesions‌) should be assigned for benign or premalignant lesions, while codes from the 11600 series (Excision, malignant lesions‌) should be reported for excision of malignant lesions.

Partnering with an experienced dermatology medical billing and coding company can ensure error-free claim submission. Expert coders and billing professionals in medical billing companies scrutinize clinical documentation to accurately report skin-related diagnoses and associated procedures. Avoiding mistakes in skin procedure coding is crucial to prevent delayed or denied payments, increased insurer scrutiny or investigation for fraud.

www.outsourcestrategies.com

918-221-7769