Dermatology Coding Alert

Question: Most of the patients who are having warts removed need to come in several times. Can we report an office visit code along with the wart removal code each time a patient comes in for treatment?

Ohio Subscriber

Answer: You probably can't report a separate office visit (99201-99215) every time your patient comes back for additional wart treatments. You can report an E/M code in addition to the procedure only when the dermatologist performs a significant, separately identifiable E/M service from the wart removal.

Example: A new patient presents with nine flat warts.

The physician examines the area and discusses treatment options before he performs the removal.

Along with 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), you can report a new-patient office visit code (99201-99205). Append modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) to the E/M code to show that this service is distinct from the E/M service inherent in 17110.

Next visit: The patient comes back in two weeks, and the dermatologist doesn't do anything other than the re-treatment.

For this visit, report only 17110. Since this service occurs after the 10-day global period for the first service, you do not need to append any modifiers to 17110.