Podiatry Coding & Billing Alert

Question: One of our providers sometimes states she “pares a callus with a Dremel tool,” and other times, she states she “smooths a callus with a Dremel tool.” My questions are these: is a Dremel tool regarded as a surgical instrument, and can you use 11055 for one or both of these situations?

AAPC Forum Participant

Answer: Even though the clinical responsibility for 11055 (Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion) states that the provider “uses a scalpel, curette, blade, or a spoon–shaped surgical instrument” in the procedure, nothing in the code descriptor specifies the instrument the provider must use to trim or pare the lesion down. Instead, the important parts of the descriptor that apply to your scenario concern what the provider does to the lesion and the number of lesions the provider pares or cuts.

For hyperkeratotic lesions, the treatment described by 11055 can involve anything from sanding and trimming to complete removal, which encompass both the paring and smoothing referred to in your provider’s notes. And if your provider smooths, pares, or removes more than one lesion on the same date of service, you’ll use 11056 (… 2 to 4 lesions) or 11057 (…more than 4 lesions), as appropriate.

Remember: For your Medicare patients, especially ones suffering from diabetes, you’ll use S0390 (Routine foot care; removal and/or trimming of corns, calluses and/or nails and preventive maintenance in specific medical conditions [e.g., diabetes], per visit)