Podiatry Coding & Billing Alert

Question: The podiatrist removed 15 warts on the patient’s foot via cryosurgery. Which CPT® code should I report — 17004 or 17111? What is the difference between these two codes?

Florida Subscriber

Answer: You should report 17111 (Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; 15 or more lesions) for the destruction of warts.

Codes 17004 (Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses), 15 or more lesions) and 17111 may look similar upon first glance, but if you read the code descriptors closely, you will see the difference between the two.

17111: The code descriptor for 17111 says this code is for the “destruction of benign lesions other than skin tags or cutaneous vascular proliferative lesions. Warts are considered benign lesions. In your case, the podiatrist used cryosurgery, a method mentioned in this code’s descriptor to remove 15 warts.

With cryosurgery, the podiatrist provides controlled destruction of skin lesions by withdrawing heat from the targeted tissue.

Note: The descriptor for 17111 mentions skin tags and cutaneous vascular proliferative lesions.

Skin tags are small flaps of tissue existing as an outgrowth on the surface of skin. You should report codes 11200 (Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions) or +11201 (Removal of skin tags, multiple fibrocutaneous tags, any area; each additional 10 lesions, or part thereof (List separately in addition to ode for primary procedure)) for the removal of skin tags.

For cutaneous vascular proliferative lesions, which are birthmarks, such as port wine stains, you should report codes 17106 (Destruction of cutaneous vascular proliferative lesions (eg, laser technique); less than 10 sq cm)-17108 (…; over 50.0 sq cm).

17004: The code descriptor for 17004 says to use this code for premalignant lesions. An example of these would be actinic keratoses.