a patient underwent paring of a single benign hyperkeratotic lesion on the back. report code

by Nathanael Grant Sr. 7 min read

What is Paring or Cutting of Benign Hyperkeratotic Lesion - DocDoc

30 hours ago Paring or cutting of benign hyperkeratotic lesions, such as corn or callus, is the primary treatment or removal method for skin defects caused by the thickening of the stratum corneum or the outermost layer of the epidermis. Since they are benign, patients who have such lesions usually wish to have them removed for cosmetic reasons. >> Go To The Portal


Answer: When the physician removes a benign hyperkeratotic skin lesion such as a corn or callus by either cutting, clipping or paring you report only one code depending on number of lesions removed. For one lesion you report 11055, for 2-4 lesions you report 11056 and more than four is reported with 11057.

Code 11055: paring or cutting of benign hyperkeratotic lesion. This pertains to corn or callus for a single lesion.

Full Answer

What is the CPT code for benign hyperkeratosis?

When the physician removes a benign hyperkeratotic skin lesion such as a corn or callus by either cutting, clipping or paring you report only one code depending on number of lesions removed. For one lesion you report 11055, for 2-4 lesions you report 11056 and more than four is reported with 11057.

What are benign hyperkeratotic lesions?

Benign hyperkeratotic lesions come in different forms, such as: 1 Corns and calluses – These are caused by thick layers of dead skin that pile up on the surface of the body and harden as a result of repeated friction ... 2 Warts 3 Eczema, which causes dry skin and scaling 4 Lichen planus 5 Actinic keratoses 6 Seborrheic keratoses

How many lesions do I need to report with code 11057?

For one lesion you report 11055, for 2-4 lesions you report 11056 and more than four is reported with 11057. You cannot report any of these codes together as they are bundled under NCCI and you cannot use Modifier 59 to bypass the edit as it not allowed.

What are the codes for CPT diagnosis?

CPT CODES: 11055 Paring or cutting of benign hyperkeratotic lesion (e.g., corn or callus); single lesion One of the following combinations is necessary to allow payment for routine foot care: 2. G0127, 11720, 11721 Primary diagnosis – 110.1, 703.8, or 703.9 Secondary diagnosis – one of the systemic diagnoses

What is the CPT code for paring of 3 Hyperkeratotic benign lesions of the skin?

CPT 11055 Definition: Paring or cutting of benign hyperkeratotic lesion; single lesion. CPT 11056 Definition: Paring or cutting of benign hyperkeratotic lesion; 2-4 lesions. Ensure that the following are easily identifiable with the documentation submitted.

What does CPT code 11055 mean?

Paring or cutting of benign hyperkeratotic lesionCPT Code. Description. 11055. Paring or cutting of benign hyperkeratotic lesion (e.g., corn or callus); single lesion. 11056.

What is procedure code 11400?

11400. EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR LEGS; EXCISED DIAMETER 0.5 CM OR LESS.

What is procedure code 11043?

CPT® Code 11043 in section: Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed)

What does CPT code 11719 mean?

CPT® 11719, Under Surgical Procedures on the Nails The Current Procedural Terminology (CPT®) code 11719 as maintained by American Medical Association, is a medical procedural code under the range - Surgical Procedures on the Nails.

What is CPT code G0127?

G0127. TRIMMING OF DYSTROPHIC NAILS, ANY NUMBER.

What does CPT code 12051 mean?

12051-Intermediate repair, face, ears, eyelids, nose, lips, mucous membranes, 2.5cm or less.

What is procedure code 11422?

CPT® Code 11422 in section: Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia.

What is procedure code 11443?

11443. EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; EXCISED DIAMETER 2.1 TO 3.0 CM.

What is CPT code 15002?

CPT® 15002 in section: Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar ... more.

What is procedure code 97605?

CPT codes 97605 and 97606 are used when negative-pressure wound therapy is all that is performed (e.g., placement of a wound vacuum on an open wound). These procedures may also be reported when the wound is debrided or excised and there is no closure (the wound vacuum is acting as a closure device).

What does CPT code 11042 mean?

11042 – Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less. +11045 – each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)

Where are hyperkeratotic lesions on the right plantar heel?

Nails are noted to be elongated and thickened, and hyperkeratotic lesions are noted to be on the right plantar heel and right foot second metatarsal head. The podiatrist debrides all ten nails and trims two lesion sites.

When did the NCCI guideline change?

The most recent change to the NCCI guideline was published in 2018, and remains in effect in 2019. It states:

General Information

CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

CMS National Coverage Policy

Language quoted from Centers for Medicare and Medicaid Services (CMS), National Coverage Determinations (NCDs) and coverage provisions in interpretive manuals is italicized throughout the policy.

Article Guidance

This article contains coding and other guidelines that complement the Local Coverage Determination (LCD) for Routine Foot Care and Debridement of Nails.

Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.

Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.