Podiatry Coding & Billing Alert

You Be the Coder:

Distinguish Between Destruction and Biopsy for Best Payment Opportunities

Published on Mon Dec 08, 2014

Question: Our podiatrist recently attended to patient with suspected malignant growths on the right toe and left foot. She diagnosed three lesions as warts and found two suspected malignancy sites. Excision through electrocautery was performed for the three warts and the physician took biopsy samples from the other two sites with partial removal. How should I code this?

New Jersey Subscriber

Answer: You should report codes 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) for treatment of flat warts and molluscum by any method. Be careful not to use the term “biopsy” or “punch biopsy removal” in your documentation or the payer may incorrectly code the procedure as a biopsy, which would result in less reimbursement.

For the biopsies, submit 11100 (Biopsy of skin, subcutaneous tissue and/or mucous membrane [including simple closure], unless otherwise listed; single lesion) for the first biopsy. For each separate biopsy after the first one, use add-on code 11101 (…each separate/additional lesion [List separately in addition to code for primary procedure]). In your case, you should submit codes 11100 and 11101 for the two lesions.

Caution: Make sure in the documentation that the biopsies have been taken from separate locations and not two biopsies from the same location.

You can use the diagnosis code 238.2 (Neoplasm of uncertain behavior of skin), 709.9 (Unspecified disorder of skin and subcutaneous tissue), or 238.9 (Neoplasm of uncertain behavior site unspecified)for the biopsy before the histopathology is known.

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