Cryotherapy

[Linda]

Hello Ladies,

I work for an Internal Med practice.  What modifier is used when a wart or skin tag is removed, then additional warts ?  I use codes 17003 and 17110,  is it 59 or 25?

[Michele]

Hi,
   The 25 modifier is for when you are billing for an E&M code (office visit, evaluation and management - 99201-99215) that is separate from another procedure being performed at the same visit.  The 59 modifier is to indicate a distinct procedural service.  If you are removing more than one skin tag or wart, the 59 modifier would be more appropriate.

Thanks
Michele

[Linda]

Thank you - just wondering, how are you compensated for this service? 

[Michele]

Hi,
   We don't get compensated directly for answering questions.  We wanted to create a friendly environment for people who all do the same thing to help each other out.  We are hoping that others will respond to people's questions if they have an answer so that we are not the only people answering questions.  We will moderate to make sure the answers are appropriate.  Also, we do offer some products and services.  In addition to being a billing service, we do credentialing/re-credentialing, NPI number applications, and other odd services.  We've written 6 ebooks about different aspects of medical billing, from Basics of Medical Billing to How To Complete a CMS Form Completely and Correctly, Line by Line, Box by Box.  We want people to spread the word about this forum so it can continue to grow, and we can all help each other out!

Good luck,
Michele

[lpfamilyphys]

I am a little late to these postings, but I stumbled across them and couldn't help but wonder: don't codes 17110 and 17003 cover the removal of 1-14 or 15 tags/warts? Why would you use a modifier at all?

Maybe I misunderstood the question?
Thanks!

[Michele]

Hi,
   You wouldn't need to use the 59 modifier if just billing for the removal of warts/skin tags.  You would just use the code appropriate for the number removed.  You would only use the 59 modifier if you were billing for say 12 warts with 17110 and you also removed a lesion and would be using 17000 that was unrelated to the skin tag removal, then the 59 modifier would be appropriate.

Boy it can get involved!

Thanks
Michele
 

[PMBS]

Hi,

I had a question.  I work for a primary care physican and she removed 7 skin tags for a patient.  I billed procedure code 11200 as 7 units to Medicare and they denied it saying that date range not valid with units submitted.  Do you know if it was appropriate to bill using the 7 units?

[Michele]

Code 11200 describes removal of up to and including 15 lesions.  So if the Dr removed 7 skin tags you would only bill the 11200 once with 1 unit.  1 Unit indicates up to 15 lesions.

Thanks
Michele

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