Podiatry Coding & Billing Alert

Question: My provider is doing the following procedure: “Bilateral lateral sided hyperkeratotic lesion to fifth MPJs consistent with IPK. At this time, a #15 blade was utilized to remove the hyperkeratotic skin over top the verucca. No 15 blade was utilized to debride all hyperkeratotic tissue until we reached the pinpoint bleeding of the verruca. Next, a cotton-tip applicator was utilized to apply 30% salicylic acid. Next a Band-Aid placed over top.” We are billing 17110 (Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions) with ICD-10-CM code L85.1 (Acquired keratosis [keratoderma] palmaris et plantaris), but we are getting denied by Medicare. Is this case coded properly?

AAPC Forum Subscriber

Answer: No. The problem lies within your ICD-10-CM code. When your podiatrist performs a 17110 service, you should report B07.0 (Plantar wart), which also includes verruca plantaris instead of L85.1. Code L85.1 is used with CPT^® codes 11055 (Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion) through 11057 (… more than 4 lesions) and requires a Q modifier with a date last seen in order to be covered.

The Q modifiers, which are used to denote class findings are as follows:

• Q7 (One class a finding)
• Q8 (Two class b findings)
• Q9 (One class b and two class c findings)

Don’t miss: When it comes to integumentary lesion destruction, you must know how many lesions were removed, the type of lesion removed, and how many were destroyed in order to report the appropriate code.