Podiatry Coding & Billing Alert

Question: A new patient came in complaining of corns and calluses on the bottom of her right foot and several toes. After performing a level-two evaluation and management (E/M) service, the podiatrist diagnosed simple corns. She then pared the corns, and the tissue was benign. What codes should I report?

Alaska Subscriber

Answer: You need to know how many corns the podiatrist pared during the visit, so check the documentation for that information.

You will then report the following codes:

• 11055 (Paring or cutting of benign hyperkeratotic lesion [e.g., corn or callus]; single lesion), 11056 (... 2 to 4 lesions), or 11057 (... more than 4 lesions) for the parings, depending on how many corns the podiatrist pared.
• 99202 (Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; straightforward medical decision making...) for the E/M service.
• Append modifier 25 (Significant, separately identi­fiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service) to 99202 to show that the E/M was significant and separately identifiable from the parings.
• Append L84 (Corns and callosities) to the paring code and 99202 to represent the patient's corns.