Submitting accurate claims for wart removal requires careful scrutiny of the documentation to determine the type and number of warts, and other factors.

1. Ensuring Accurate
Reporting of Treatment
or Removal of Warts
Submitting accurate claims
for wart removal requires
careful scrutiny of the
documentation to determine
the type and number of
warts, and other factors.
Outsource Strategies International
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Tulsa, OK 74133

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Medical billing outsourcing companies help dermatologists submit accurate
claims for all the procedures and services they provide. A common condition,
warts are small, benign growths caused the human papillomavirus (HPV). Coding
and billing for wart treatment or removal requires careful scrutiny of the
physician’s documentation to determine the type of wart, exact wart removal
method, and number of warts removed.
Warts appear as small lumps on the skin of the hands and feet. There are different
types of warts. They can occasionally itch or bleed, though only some types are
painful. Warts have an irregular surface and appear in different shapes such as
round and oval. They can be firm and raised and vary in size, from less than 1mm
to more than 10mm (1cm) in diameter. Warts are diagnosed using the following
methods:
- Examination of the wart
- Scraping off the top layer of the growth to check for clotted blood vessels, a
common symptom of the condition
- Performing a shave biopsy (removing a section of the wart) and conducting
a lab test to rule out skin conditions and diseases
Treatment and/or removal of warts include one or more of the following
procedures:
o Cryotherapy (super-freezing tissue)
o Electrosurgery - burning the skin via an electrical charge
o Excision or surgical curettage - surgical removal (scraping or cutting) of
wart tissue using a scalpel or a small, sharp, spoon-shaped tool
o Shave excision – using a sharp razor to remove the growth
o Biopsy – removal of tissue for examination under a microscope

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o Intralesional injection therapy or topical immunotherapy
o Laser therapy – using laser light to burn and destroy the wart tissue
o Chemosurgery - using cauterets
The aim of all wart treatments is to irritate the skin and prompt the body's own
infection-fighting cells to remove the warts. However, the HPV virus that causes
warts stays in the body even after wart treatment, and so the warts can come back,
according to the U.S. National Library of Medicine.
Both primary care physicians and dermatologists perform wart removal. Medicare
and many health insurance companies cover wart removal. Coverage is based on
medical necessity. If the wart treatment is largely cosmetic, payers may not cover
it. Providers need to have a clear idea about payer coverage rules to get reimbursed
for wart removal. The CPT code ranges for treatment or removal of warts are as
follows:
11300-11313: Shaving of epidermal or dermal lesions
11400-11446: Excision, benign lesions
17000-17004: Destruction, (such as laser surgery, electrosurgery, cryosurgery,
chemosurgery, surgical curettement), premalignant lesions (such as actinic
keratoses)
17110-17111, 17250: Destruction, (such as laser surgery, electrosurgery,
cryosurgery, chemosurgery, surgical curettement), of benign lesions other than
skin tags or cutaneous vascular lesions
In 2019, six new skin biopsy codes have been introduced (11102-11107) to
differentiate between tangential, punch and incisional skin biopsies. Points to note:

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o A tangential biopsy involves a shave, scoop, saucerize or curette type of
biopsy and does not involve removal of lesion, the new codes should not be
confused with the shaving of lesion” codes, 11300-11313.
o CPT 11300-1313 are limited to use for skin only and are appropriate when a
portion of an entire cutaneous lesion is tangentially removed with a sharp
blade, with the depth of the removal extending no deeper than into the
dermis.
o CPT distinguishes a simple excision (codes 11400-11646) from a biopsy or
shave via 2 criteria:
- the excised lesion must be removed through the dermis
- the excision includes margins
o If a combination of different types of skin biopsies is performed, the highest
code in the hierarchy is reported for the primary code and the add-on code
for the second biopsy.
To ensure correct wart removal claim billing and reimbursement, medical coders
should examine the physician’s documentation carefully to:
 Determine the wart removal method and number of warts removed: For
removal of 14 or less warts, use 17110 (Destruction [e.g., laser surgery,
electrosurgery, cryosurgery, chemosurgery, surgical curettement], of benign
lesions other than skin tags or cutaneous vascular proliferative lesions; up to
14 lesions) and one unit of service. For removal of 15 or more warts, bill
CPT 17111 (Destruction [e.g., laser surgery, electrosurgery, cryosurgery,
chemosurgery, surgical curettement], of benign lesions other than skin tags or
cutaneous vascular proliferative lesions; 15 or more lesions) with one unit of
service.

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 Determine the correct type of wart removed: It should be determined if the
wart is a common wart, a plantar wart or a flat wart. CPT codes 17110 and
17111 should be used for flat warts and molluscum contagiosum destruction,
and 17000 and 17003 are appropriate to report plantar wart removal. It is
also important to check if the growth is documented as benign,
premalignant, or malignant. Codes from the 11400 series (Excision, benign
lesions…) should be assigned for benign or premalignant lesions, while
codes from the 11600 series (Excision, malignant lesions…) should be
reported for excision of malignant lesions.
Partnering with an experienced dermatology medical billing and coding company
can ensure error-free claim submission. Expert coders and billing professionals in
medical billing companies scrutinize clinical documentation to accurately report
skin-related diagnoses and associated procedures. Avoiding mistakes in skin
procedure coding is crucial to prevent delayed or denied payments, increased
insurer scrutiny or investigation for fraud.