# Verruca Surgery



## SRCoding (Mar 16, 2010)

When billing for wart removal/destruction I always use 17110/17111 codes in the office setting, however when performed in a surgery center his dictation is more complex but I have a hard time finding a code outside of the 17110/17111 set that fits.  I've always been unsure about the surgical currettement potion of 17110 code description and if a blunt dissection would fall under that or if this would be considered more complex and I need to be using a different code.  Here is what he dictates- please let me know if you think there is a better code for this than the 17110.

Operation Performed: Blunt dissection with cautery of plantar verruca.

Procedure: With use of Beaver blade, the verruca sub left 4th was circumscribed down to the level of basal lamina. With use of pickups, the verruca was lifted and a Beaver blade was then used to free it from the underlying basal laminar layer. At this time a bovie was used to cauterise the base and the area was inspected to assure complete removal.

(This was performed on 4 verrucas- in other areas of the foot)

Thank you,
SR


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## rmelissa (Mar 16, 2010)

"For destruction of common or plantar warts, see 17110, 17111." The CPT 2010 book says that those are the best codes for that procedure. I hope that helped, it looks like you're right on track.


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## eblanken (Mar 16, 2010)

Podiatry is not my strength but you might look at the 11300-11308 series which seem to fit more of your blunt dissection. 
The plain english description reads as: "A raised lesion is removed by shaving from the scalp, neck, hands, feet, or genitalia. The physician applies local anesthesia to the excision site. The scalpel is held parallel to the skin surface and the lesion is removed at its base. Electrocautery or chemical cautery may be used to control bleeding." 

On the other hand the description for 17110 doesn't seem to fit as it describes the surgical curettement as "scraping." The plain english description for 17110 fully reads as: "Benign lesions other than skin tags or cutaneous vascular proliferative lesions are destroyed by laser surgery, electrosurgery, cryosurgery, chemosurgery, or surgical curettement. A local anesthetic may be administered. The type of destruction depends on the lesion type and location and may include use of a laser, heat or thermal energy (electrosurgery), cold or freezing (cryosurgery), chemical destruction, or scraping (surgical curettement)." 

Furthermore, I personally had plantar warts excised under general anesthesia at a surgery center and my physician billed it as 11420 for each of the 5 lesions but mine were also deep excisions that were carried down to the fascia. Hope some of this info helps.


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## TammyHF (Mar 17, 2010)

CPT 17110 would be the correct code with a 22 modifier. Increase the billed amount and send this claim on paper with the operative notes showing why the wart removal was performed under general anesthesia and reasoning of increased procedural service (ie increased intensity, time, technical difficulty of the procedure, severity of patient's condition, physical and mental effort required). With my experience when a wart(s) removal is performed under general anesthesia the procedure is precertified by the insurance company before the procedure, if not insurance might deny the claim as not being medically necessary.


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