CPT Code 17110: Destruction of Benign Lesions

What is CPT code 17110?

CPT code 17110 refers to the destruction of up to 14 benign skin lesions, such as warts, molluscum contagiosum, milia, or skin tags, using methods such as cryotherapy, laser surgery, electrosurgery, or chemical treatment. This code is used primarily to remove benign, symptomatic, or cosmetically concerning lesions. The procedure helps alleviate discomfort and improve the appearance of the skin.

When billing for CPT code 17110, it is important to ensure that the lesions are benign and the procedure is medically necessary. The same physician should perform the service, and any lesion removal should be clearly documented in the patient's medical records, specifying the method used and the number of lesions treated. The removal of cutaneous vascular lesions or skin tags may also be included under this code if the conditions meet the defined criteria.

For reimbursement, it's essential to understand that while Medicare administrative contractors typically cover the procedure, certain exclusions, such as cosmetic surgery, may apply.

CPT code 17110 documentation requirements

To ensure proper billing and reimbursement for CPT Code 17110, accurate and thorough documentation is essential. The following key elements should be included in the medical records:

• Code description: The medical records must include a detailed description of each lesion type, specifying whether skin tags, cutaneous vascular lesions, or other benign skin lesions are present. The size, number, and location of the lesions should also be documented to support the procedure's medical necessity.
• Destruction technique: The documentation must describe the techniques used for lesion removal, such as cryotherapy, laser surgery, electrosurgery, or chemical treatment. This helps clarify the nature of the surgical procedure performed.
• Patient consent and post-procedure details: Clear documentation of the patient’s consent for the procedure is necessary. Additionally, note the immediate post-procedure response, including any complications that may have arisen. This will support the medical billing services and ensure accurate coding practices.
• Billing and coding: The records should reflect billing and coding information, ensuring the procedure aligns with established guidelines for CPT Code 17110. This must be noted if the service is statutorily excluded, such as for cosmetic purposes, to avoid reimbursement issues.

Healthcare providers can ensure that they follow appropriate coding practices and maintain compliance with the reimbursement process, whether through Medicare benefits or other insurance providers.

CPT code 17110 billing guidelines

CPT Code 17110 is billed once per encounter for the destruction of 1-14 benign lesions. It is essential to clearly document the exact number of lesions being treated.

When billing for this procedure, it is crucial to document the medical necessity for the treatment, particularly distinguishing cosmetic procedures from those that are medically necessary, as cosmetic procedures are generally statutorily excluded from insurance reimbursement. This ensures that billing practices align with insurance requirements and avoid denial of claims.

Detailed documentation should include a description of the lesions treated (e.g., plantar warts, skin tags, etc.) and the methods of destruction used, such as cryotherapy, electrosurgery, or laser treatments. This provides the significant and separately identifiable details necessary for accurate reimbursement.

Providers should also ensure that the procedure code is correctly applied to reflect the specific treatment and that all management services are clearly documented for proper coding.

Other CPT codes for destruction of benign lesions

In addition to CPT Code 17110, there are several other CPT codes that can be used for the destruction of benign lesions. These codes vary based on the type, number, and method of destruction, as well as the location of the lesions. Below are some examples of other CPT codes commonly associated with the removal of benign skin lesions:

• CPT code 17106: This code is used to destroy 1 to 14 benign lesions, typically performed using methods like 17110, such as cryotherapy or electrosurgery. Ensuring accurate documentation of the tags or cutaneous vascular lesions being treated is important.
• CPT code 17108: Used when treating 15 or more benign lesions, this code captures larger-scale treatments that may involve multiple lesions, such as skin tags or cutaneous lesions. Proper coding will help maximize reimbursement for services rendered.
• CPT code 17111: This code describes destruction of benign lesions in a more specialized or separate setting, such as in an outpatient or dermatologic practice. Documenting a separately identifiable evaluation and any specific procedural details is important.

Providers must follow the process carefully, documenting all procedures and matching the appropriate diagnosis codes for the lesions treated. If the service is statutorily excluded, such as in cases of cosmetic procedures, the correct code must be used to reflect this exclusion.

For Medicaid services, consult the applicable coding guidelines, as certain procedures or treatments may have different requirements or limitations.