Wiki Shaving and cryosurgery on the same wart

[jonique.dietzen]

A patient came in with a reoccurring plantar wart. The physician started by shaving the 4mm lesion flat then applied liquid nitrogen twice.

Do I code for both the shaving 11305 and the destruction 17110? Because none of the new replacements for modifier 59 would be appropriate so should I only code for the destruction?

 

[BenCrocker]

What was the POSTPROCEDURE DX?

 

[JesseL]

I would code 17110 only. 11305 is for shave removal of the entire lesion and I don't think that's what your provider did.

I think what your provider did was pared down excess skin to get closer to the root of the wart itself for the cryo to be more effective.

If it was the other way around where the provider's intent was to tried to shave remove the entire lesion by transverse incision and then cryoed the area then I'd probably code the shave code but because of your statement where you said your provider was trying to "shave it flat" that gives me the impression that he's trying to pare or curette it down as opposed to removing it in one go.

There's a code for paring hyperkeratotic lesions, 11055, but I wouldn't bill it since it bundles with 17110 and its everything done on one lesion.