for podiatry wart removal(15 lesions) which cpt code is correct to use 17004 or 17111? whats the difference between the 2? :confused:
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Tag Archives: Wart
Wart Excision with Flap Repair
Good morning!
I have run into an issue with billing for a wart removal that resulted in the physician having to perform a rotational rhomboid-type flap repair. The wart required the flap closure due to location and size. See the operative report below.
We billed just the 14040 for the repair, as the excision is included, but the insurance company (Blue Cross) is denying stating that the diagnosis of plantar wart doesn’t substantiate the CPT code billed. I tried to appeal with records for medical necessity, explaining that the defect required a more complex type of closure. But they upheld that denial.
Any suggestions on coding for this?
PREOPERATIVE DIAGNOSIS:
Plantar wart, left forefoot.
POSTOPERATIVE DIAGNOSIS:
Plantar wart, left forefoot.
PROCEDURES:
1. Local rotational flap rhomboid-type flap.
2. Excision of plantar wart, left foot.
ANESTHESIA:
General.
ESTIMATED BLOOD LOSS:
Less than 25 mL.
COMPLICATIONS:
None.
INTRAOPERATIVE FINDINGS:
Intraoperatively there was noted to be a well-circumscribed plantar wart in the plantar aspect of the left foot. Measured approximately
1 cm in diameter.
DESCRIPTION OF PROCEDURE:
Patient was brought to the operating room and placed on the operating table in supine position. Following adequate anesthesia via
general anesthesia, left lower extremity was prepped and draped in usual sterile manner. Left lower extremity was then elevated,
exsanguinated, and ankle tourniquet inflated to 250 mmHg. Attention directed in the plantar aspect of the left foot where this lesion
was excised circumferentially, was measured approximately 1 cm in diameter. After full excision, the lesion was sent to Pathology.
The rhomboid flap on either end of the proximal and distal extents of the lesion were then elevated and rotated into place for proper
closure. The wound and defect as well as the flap were sutured in place using 4-0 nylon stitch after flushing with copious amounts of
sterile saline. Sterile dressings were then applied after infiltrating with Marcaine. She left the operating room for recovery room with
vital signs stable and vascular status intact. She was given postop instructions, postop pain medication. Follow in my office in 7 to
10 days.
Thank you in advance for your help!
Plantar Wart
How do we code plantar wart destruction with paring and cryosurgery? 9 total were done.
thank you
thank you
Billing Level office visits with Wart Destruction
Should a 99211 be bill with 46924 when billing Medicaid? Should 99212 be bill with 46900 when billing Medicaid? Is not the office visit bundle or apart of the destruction of the wart?