Integumentary coding made easy

Here are some of the CPT intugmentry system codes that cause confusion and need better understanding.

Paring and Cutting: Paring means debridement of lesion not destruction
CPT codes 11055-11057 represent paring and cutting of benign hyperkeratotic lesions like corns and callus. These codes are not for all benign lesions but only for any benign lesion that can be classified as hyperkeratotic corns and callus are just two examples given in the CPT assistant but these codes can be used for any hyperkeratotic lesions. For destruction of hyperkeratotic lesion 17000-17004 should be used.

Medicare does not reimburse for routine foot care. CPT Codes 11055-11057 will only be reimbursed by Medicare if the treatment is medically necessary. The first of the two ICD-9-CM Codes must be:

700 Corns and callosities
701.1 Keratoderma acquired
757.39 Other specified congenital anomalies of skin

The second ICD-9-CM Code must be one of the following:

686.9 Unspecified local infection of skin and
subcutaneous tissue
729.5 Pain in limb

Skin biopsy codes 11100-11101 are for per lesion so when a physician takes more than one biopsy sample of the same lesion at the same session only 11100 should be coded not 11101. There is a separate code for biopsy of eyelid 67810.

Skin Tags: Skin tags are also known as skin polyps or fibroepithelial polyps, Soft fibromas, or papilloma. Skin tag treatment include excision, cryotherapy, ligation, shave biopsy, electrocautery, laser therapy, curettage and cautery, and skin biopsy. CPT codes 11200 and 11201 can be reported for removal of skin tags by any method.

Excision
CPT defines excision as full-thickness (through the dermis) removal of a lesion and includes a simple closure.