6 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.
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.
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
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.
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
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.
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.
11400. EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR LEGS; EXCISED DIAMETER 0.5 CM OR LESS.
CPT® Code 11043 in section: Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed)
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.
G0127. TRIMMING OF DYSTROPHIC NAILS, ANY NUMBER.
12051-Intermediate repair, face, ears, eyelids, nose, lips, mucous membranes, 2.5cm or less.
CPT® Code 11422 in section: Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia.
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.
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.
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).
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)
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.
The most recent change to the NCCI guideline was published in 2018, and remains in effect in 2019. It states:
CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
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.
This article contains coding and other guidelines that complement the Local Coverage Determination (LCD) for Routine Foot Care and Debridement of Nails.
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.
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.