CODING Q&A
Proper Coding for Skin Tag Removal,
Workers Comp Issues, and Off-Hour Visits
■ DAVID STERN, MD, CPC
Q .
Are you able to bill the following two codes to-
gether with a modifier: 17110 (Destruction [e.g., laser
surgery, electrosurgery, cryosurgery, chemosurgery, surgi-
cal curettement], of benign lesions other than skin tags or
cutaneous vascular proliferative lesions; up to 14 lesions)
17111 (15 or more lesions)?
- Question submitted by Julie Briggs
These are mutually exclusive codes. You can use
17110 if the physician destroys 14 or less benign le-
sions (usually warts). If you destroy 15 or more lesions, then
use 17111. You may not report both these codes for the same
patient on the same day.
A. Q .
Do you use this same method for coding CPT codes
11200 and 11201 for removing skin tags?
The CPT coding is quite different for removal of skin
tags. For skin tag removal, you code 11200 for remov-
ing the first 15 lesions, and then you add code 11201 for re-
moval of each additional 10 lesions. Thus, the payors expect
you to use 11200 along with 11201, and you many even code
11201 multiple times on a single visit.
A. Q .
How do I code for the removal of 24 skin tags?
Could I round up and use code 11201 (along with
11200) even though the provider only removed an additional
nine skin tags, so she did not quite remove the required “ad-
ditional 10 lesions?”
For removal of the first 15 skin tags, use code 11200,
then for removing the additional nine skin tags code
with 11201-52. The modifier-52 signifies “reduced services,”
indicating that the physician removed additional skin tags,
A. David Stern is a partner in Physicians Immediate Care and
chief executive officer of Practice Velocity. Dr. Stern and Frank
H. Leone, MBA, MPH, are scheduled to speak at a pair of half-
day seminars, Urgent Care: 40 Ways to Increase Profitability,
in Tampa and Boca Raton, FL July 25 and 26. For more in-
formation about the seminars, call Megan Montana at
(800) 666-7926, extension 13. Dr. Stern may be contacted at
dstern@practicevelocity.com. 34
JUCM T h e J o u r n a l o f U r g e n t C a r e M e d i c i n e | J u n e 2 0 0 8
but did perform a portion (i.e., removal of nine, rather than
10, skin tags) of the work that the actual code includes.
Q .
If we shave off a skin tag, should we code the pro-
cedure with CPT code 11300 (shaving of epidermal
or dermal lesion…)?
You should use code 11200 for any sharp excision
(including shaving) of skin tags.
A. Q .
In addition to the diagnosis code for the injury, do
I use V71.3 (observation following accident at work)
for each follow-up visit for injuries covered under the work-
ers compensation act of my state?
- Question submitted by Shanin Skinner, Ontario, OR
No; this code is not intended for use with routine fol-
low-up visits for workers compensation cases. You
should reserve the code V71.3 for injuries or possible injuries
that require observation of the patient, rather than for
rechecks of work comp injuries. I am unaware of any pay-
ors that are requiring providers to use this code.
This code could be used, for example, for a patient who
needed to be held for observation after contact with a pes-
ticide or other toxic substance, such as carbon monoxide.
A. Q .
If a patient is covered under the workers compensa-
tion act and is treated for two separate injuries, can
you bill two E/M codes for the separate injuries or is it just
one billing for multiple injuries? For example, an employee
injured her neck while lifting a patient, and she injured her
ankle when she tripped over a leg of a chair.
- Name withheld, California
According to CMS guidelines, you would only code a
single CPT. However, many work comp payors will
accept completely separate documentation for two sepa-
rate visits and two separate E/M codes for these visits if
these visits are for separate work comp injuries.
A. Continued on page 36.
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