βοΈ CPT 17110 β Destruction of Benign Lesions Other Than Skin Tags or Cutaneous Vascular Proliferative Lesions; Up to 14 Lesions
Quick Reference
wRVU: 1.18 | Global Period: 010 (10 days) | Assistant Payable: β No | Bilateral Indicator: 2
π Clinical Description
CPT 17110 describes the physical destruction of up to 14 benign skin lesions per session using any of the following modalities: cryosurgery (liquid nitrogen), electrosurgery, laser surgery, chemosurgery (e.g., cantharidin, trichloroacetic acid), or surgical curettement. The code is reported once per session regardless of the number of lesions treated (1 through 14); it is the lesion count, not the anatomic site or modality, that distinguishes 17110 from its sibling 17111 (15 or more lesions). Two critical exclusions define the scope of this code: skin tags (reported under 11200-11201) and cutaneous vascular proliferative lesions (reported under 17106-17108) are expressly outside the 17110/17111 family.
The most common conditions reported under this code include verrucae (viral warts), caused by human papillomavirus (HPV), molluscum contagiosum, caused by a poxvirus, and seborrheic keratoses, benign keratinocytic proliferations that increase in prevalence with age. When left untreated, verrucae and molluscum can spread via autoinoculation or close contact; symptomatic or rapidly spreading lesions, or those in immunocompromised patients, typically meet medical necessity thresholds. Cosmetic removal of asymptomatic seborrheic keratoses is generally not covered by Medicare or most payers β documentation must reflect a clinical indication (irritation, bleeding, recurrent infection) to establish medical necessity.
This procedure may be performed in the following clinical contexts:
- Verruca vulgaris (common warts) β HPV-induced exophytic growths, most commonly on the hands and periungual regions; cryotherapy with liquid nitrogen is the first-line office-based destruction method
- Plantar warts (verruca plantaris) β Endophytic warts on the weight-bearing surface of the foot; may require more aggressive or repeated cryotherapy cycles due to depth and hyperkeratotic overlying tissue
- Molluscum contagiosum β Poxvirus lesions most common in children and immunocompromised adults; curettement, cantharidin application, or cryotherapy are standard; high lesion counts may escalate to 17111
- Flat warts (verruca plana) β Low-profile HPV lesions, often numerous, particularly on the face and dorsal hands; gentle destruction required at facial sites to minimize scarring
- Inflamed or symptomatic seborrheic keratoses β Benign pigmented keratinocytic proliferations that bleed, catch on clothing, or become inflamed; medical necessity must be explicitly documented; cryotherapy or curettement most common
π¬ Anatomical & Procedural Considerations
| Modality | Mechanism | Key Notes |
|---|---|---|
| Cryosurgery (Liquid Nitrogen) | Rapid freeze-thaw cycle destroys intracellular water, causing ice crystal formation, cell membrane rupture, and ischemic necrosis of the lesion and its blood supply | Most widely used method in U.S. office practice; applied via spray canister or cotton-tipped applicator; freeze time and number of cycles vary by lesion type and thickness; no biopsy specimen is obtained β tissue is destroyed in situ |
| Electrosurgery (Electrodesiccation / Fulguration) | High-frequency alternating current delivered through an electrode desiccates or fulgurates the lesion | Precise control of depth; commonly used for isolated or periungual warts and for curettement-assisted destruction; local anesthesia typically required |
| Laser Surgery (COβ / Nd:YAG / PDL) | Laser energy is absorbed by tissue chromophores, causing ablation or coagulation of the lesion | COβ laser used for resistant or recurrent verrucae; pulsed-dye laser (PDL) targets the lesionβs blood supply; laser modality does not change the code β 17110 covers all methods equally |
| Chemosurgery | Application of caustic agents (e.g., cantharidin, mono- or trichloroacetic acid, podophyllin) to chemically destroy the lesion | Cantharidin is commonly applied for molluscum in pediatric patients; provider must document chemical agent and method of application; in-office application required |
| Surgical Curettement | Mechanical scooping or scraping of the lesion using a curette; typically preceded by cryotherapy or local anesthesia | Combined cryo-curettement is common for plantar warts; when curettement alone is used, the intent must be complete destruction (not biopsy) β if tissue is submitted for pathology, a biopsy code (11102-11107) may be more appropriate |
Clinical Pearl
The modality does not affect code selection for 17110 β cryotherapy, electrosurgery, laser, chemosurgery, and curettement all collapse into the same code. What drives code selection is (1) the lesion count (1-14 = 17110 vs. 15+ = 17111), (2) the lesion type (benign, not skin tag, not vascular), and (3) the intent (destruction, not excision or biopsy). The operative/procedure note must document the exact number of lesions treated, their anatomic location(s), the type or diagnosis of each lesion, and the method of destruction to survive audit.
β Procedure Includesβ¦
- Pre-procedure assessment and lesion evaluation bundled into the global payment (routine pre-procedure E/M is not separately billable)
- Local anesthesia (topical or injectable) when used β not separately reportable
- Preparation and draping of the treatment site(s)
- Physical destruction of each lesion using the documented method (cryosurgery, electrosurgery, laser, chemosurgery, or curettement)
- Wound care instructions and dressing application at the treated site(s)
- Documentation of: number of lesions treated, anatomic location(s), type/diagnosis of each lesion, and method of destruction
β Excludes / Do Not Report Together
| Code | Description | Relationship to 17110 |
|---|---|---|
| 17111 | Destruction of benign lesions other than skin tags or cutaneous vascular proliferative lesions; 15 or more lesions | Mutually exclusive with 17110 based on lesion count; report 17111 when 15 or more qualifying benign lesions are destroyed in the same session β never report both 17110 and 17111 for the same session |
| 11200 | Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions | Skin tags are explicitly excluded from the 17110/17111 family; when skin tags AND qualifying benign lesions are both destroyed in the same session, 11200 and 17110 may be reported together with modifier -59 on the separately identifiable service |
| 17000 | Destruction of premalignant lesion (e.g., actinic keratosis); first lesion | Premalignant lesions (actinic keratoses) are reported under the 17000-17004 family, not 17110/17111; the two families may be reported together in the same session for distinctly different lesion types β do not cross code families |
| 17106 | Destruction of cutaneous vascular proliferative lesions; less than 10 sq cm | Cutaneous vascular proliferative lesions are explicitly excluded from 17110; report 17106-17108 for hemangiomas, port-wine stains, and similar vascular lesions |
| 11102-11107 | Tangential, punch, or incisional biopsy of skin lesion | Destruction (17110) implies no specimen retrieval; if the operative note documents that tissue was submitted to pathology, reconsider code selection β 17110 and a biopsy code generally cannot be reported for the same lesion at the same session |
| 11055 | Paring or cutting of benign hyperkeratotic lesion; single lesion | Paring of a wart (11055-11057) and subsequent destruction (17110) at the same site during the same session are not separately billable; paring is preparatory to destruction and is bundled; report 17110 only |
| E/M codes (992xx / 920xx) | Office visit, any level | Separately reportable only when modifier -25 is appended to the E/M code, documenting a significant, separately identifiable E/M service beyond the routine pre-procedure lesion assessment |
Bundling Alert β Global Period is 010, Not 000 or 090
CPT 17110 carries a 10-day (010) global period, not a same-day (000) or 90-day (090) global. All related follow-up visits β wound checks, dressing changes, and complication management directly related to the destruction β within 10 calendar days of the procedure date are bundled into the 17110 payment and cannot be billed separately. The most common audit finding for this code family is a wound check or nurse visit billed within the global window without a supporting modifier. If a patient returns within the 10-day global window for a condition unrelated to the lesion destruction, append modifier -24 to the E/M code and document the unrelated nature explicitly. Do not confuse this with the 90-day global of complex excisions (11600-11646).
π³ Code Tree β Surgery: Integumentary System β Destruction
CPT 17000-17286 Surgery: Integumentary System β Destruction
β
βββ 17000-17004 Destruction of Premalignant Lesions (e.g., Actinic Keratoses)
β βββ 17000 Destruction, premalignant lesion; first lesion (Global: 010)
β βββ 17003 Each additional lesion, 2-14 (add-on; list separately in addition to 17000) (Global: ZZZ)
β βββ 17004 Destruction of premalignant lesions; 15 or more lesions (Global: 010)
β
βββ 17106-17108 Destruction of Cutaneous Vascular Proliferative Lesions
β βββ 17106 Destruction, cutaneous vascular proliferative lesions; less than 10 sq cm (Global: 010)
β βββ 17107 10.0-50.0 sq cm (Global: 010)
β βββ 17108 over 50.0 sq cm (Global: 090)
β
βββ 17110-17111 Destruction of Benign Lesions (Excl. Skin Tags and Vascular Lesions)
β βββ βΆβΆ 17110 ββ Destruction, benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions β YOU ARE HERE (Global: 010)
β βββ 17111 15 or more lesions (Global: 010)
β
βββ 17250 Chemical cauterization of granulation tissue (proud flesh, not including wound closure) (Global: 010)
π° RVU & Reimbursement Profile
| Component | Value |
|---|---|
| Work RVU (wRVU) | 1.18 (verify against current CMS MPFS for applicable year) |
| Global Period | 010 (10 days) |
| Bilateral Indicator | 2 β Bilateral adjustment does not apply; the code value already encompasses treatment of multiple lesions across any body region per session regardless of laterality; RT, LT, and -50 modifiers are not applicable to this code |
| Assistant Surgeon | β Not payable |
| Co-Surgeon | β Not applicable |
| Team Surgery | β Not applicable |
| PC/TC Split | β No β procedure code only (Indicator 0) |
| Modifier -51 Exempt | No β subject to multiple procedure reduction when billed alongside other surgical procedures |
| Anesthesia | Topical or local infiltration anesthesia is bundled; no separate anesthesia billing expected for benign lesion destruction in the office or ASC setting |
Bilateral Billing Rules
CPT 17110 has a bilateral indicator of 2, meaning the standard Medicare 150% bilateral payment adjustment does not apply, and RT, LT, and -50 modifiers are not applicable to this code. The code captures destruction of all qualifying lesions across the entire body (up to 14) in a single session, regardless of which side of the body they are located on β there is no meaningful anatomic laterality distinction in the payment methodology. Billing 17110-RT and 17110-LT as two separate lines for lesions on each side is incorrect and will generate a duplicate-service denial.
π·οΈ Modifier Reference
| Modifier | Name | When to Apply |
|---|---|---|
| -25 | Significant, Separately Identifiable E/M | Applied to the E/M code β not 17110 β when an office visit is performed on the same date; documentation must support a separate, medically necessary evaluation beyond the routine pre-procedure lesion assessment; the E/M note must stand alone as a complete, independent service |
| -24 | Unrelated E/M During Postoperative Period | Applied to the E/M code when a patient returns within the 10-day global window for a condition unrelated to the benign lesion destruction; document the unrelated nature explicitly and completely in the note |
| -51 | Multiple Procedures | When 17110 is performed alongside other surgical procedures at the same session; apply to the lower-valued code per standard multiple procedure reduction rules |
| -59 | Distinct Procedural Service | When payers inappropriately bundle 17110 with another procedure; documents distinct lesion type (e.g., benign lesion destruction separate from skin tag removal 11200), separate anatomic site, or independent service |
| -52 | Reduced Services | Procedure partially completed β document reason (e.g., patient intolerance, incomplete session) |
| -53 | Discontinued Procedure | Procedure stopped due to patient safety concern; document reason thoroughly in the procedure note |
π©Ί Common ICD-10-CM Pairings
Viral Warts (Verrucae)
| ICD-10 Code | Description | HCC? | Clinical Notes |
|---|---|---|---|
| B07.0 | Plantar wart | β No | Most specific code for warts on the plantar surface of the foot; document anatomic location as βplantarβ or βsole of footβ; cryotherapy may require multiple sessions due to hyperkeratotic overlying skin |
| B07.8 | Other viral warts | β No | Use for verruca vulgaris (common wart), verruca plana (flat wart), filiform wart, and periungual wart when specifically documented; more specific than B07.9 when a named wart type other than plantar is documented |
| B07.9 | Viral wart, unspecified | β No | Least-specific wart code β use only when provider documentation does not name the wart type or location; query provider when possible to drive B07.0 or B07.8 specificity |
Molluscum Contagiosum
| ICD-10 Code | Description | HCC? | Clinical Notes |
|---|---|---|---|
| B08.1 | Molluscum contagiosum | β No | Poxvirus skin infection presenting as pearlescent, umbilicated papules; most common in children and immunocompromised adults; high lesion counts may escalate to 17111 (15+ lesions); document number of lesions treated |
Anogenital Warts
| ICD-10 Code | Description | HCC? | Clinical Notes |
|---|---|---|---|
| A63.0 | Anogenital (venereal) warts | β No | HPV-related condylomata acuminata; document location as anogenital or perianal; may require more frequent sessions; payer prior authorization may be required |
Seborrheic Keratoses
| ICD-10 Code | Description | HCC? | Clinical Notes |
|---|---|---|---|
| L82.0 | Inflamed seborrhoeic keratosis | β No | Use when provider explicitly documents irritation, inflammation, bleeding, or infection of the keratosis; inflamed status strengthens medical necessity documentation for payer coverage |
| L82.1 | Other seborrhoeic keratosis | β No | Use for non-inflamed seborrheic keratoses; Medicare and most payers do not cover cosmetic removal β documentation must reflect a clinical indication (bleeding, irritation, confusion with melanoma requiring treatment) to support coverage |
Other Hypertrophic and Benign Proliferative Disorders
| ICD-10 Code | Description | HCC? | Clinical Notes |
|---|---|---|---|
| L91.8 | Other hypertrophic disorders of the skin | β No | Use for hypertrophic, hyperkeratotic, or other non-classified benign proliferative skin lesions documented as such; not a substitute for more specific wart or keratosis codes when those are documented |
Coding Specificity Reminder
The most common ICD-10-CM specificity gap for 17110 pairings is failure to distinguish wart type β defaulting to B07.9 (unspecified) when the provider has documented a plantar wart (B07.0) or a named wart variant (B07.8). For seborrheic keratoses, the critical axis is inflamed (L82.0) vs. non-inflamed (L82.1) β the distinction directly affects payer coverage determination. Query the provider when documentation is silent on wart type, lesion location, or inflammatory status. ICD-10-CM specificity requirements are not optional and are the first line of defense in a medical necessity audit.
π₯ MS-DRG Considerations (Inpatient)
Inpatient Coding Reminder
CPT 17110 is performed exclusively in the outpatient, office, or ambulatory surgical center setting. There are no routine MS-DRG assignments for this procedure β inpatient admission for destruction of up to 14 benign skin lesions would not be supported by any payer, MAC, or utilization review body under any clinical scenario. If a patient is admitted for an unrelated condition and benign skin lesion destruction is incidentally performed during the stay, an ICD-10-PCS Destruction code from Table 0H5 (Skin and Breast) is assigned, but it will not function as an OR procedure for DRG grouping purposes and will not drive a surgical DRG. No MDC or DRG family applies to this procedure as a driver of inpatient admission. See the ICD-10-PCS section below.
π§ ICD-10-PCS Equivalents (Inpatient Facility Coding)
Note
Inpatient PCS coding for benign skin lesion destruction is rare and will virtually never drive a DRG or inpatient admission. When assigned during a stay for an unrelated condition, the applicable root operation is Destruction (5) β physical eradication of all or part of a body part by the direct use of energy, force, or a destructive agent β from Table 0H5 (Medical and Surgical / Skin and Breast / Destruction). The approach is always External (X) for skin surface lesion destruction. Per ICD-10-PCS Official Guidelines, each distinct body part treated may require a separate code line; body part selection follows the specific anatomic site documented in the operative note.
| PCS Code | Full Description | Applicable Site |
|---|---|---|
0H50XZZ | Destruction of Skin, Scalp, External Approach | Scalp verrucae or lesions |
0H55XZZ | Destruction of Skin, Chest, External Approach | Trunk β anterior chest |
0H56XZZ | Destruction of Skin, Back, External Approach | Trunk β back/posterior |
0H57XZZ | Destruction of Skin, Abdomen, External Approach | Abdominal skin lesions |
0H5BXZZ | Destruction of Skin, Right Upper Arm, External Approach | Right upper extremity lesions |
0H5CXZZ | Destruction of Skin, Left Upper Arm, External Approach | Left upper extremity lesions |
0H5HXZZ | Destruction of Skin, Right Upper Leg, External Approach | Right lower extremity lesions |
0H5JXZZ | Destruction of Skin, Left Upper Leg, External Approach | Left lower extremity lesions |
0H5LXZZ | Destruction of Skin, Right Foot, External Approach | Right plantar warts and foot lesions |
0H5MXZZ | Destruction of Skin, Left Foot, External Approach | Left plantar warts and foot lesions |
PCS Character Analysis β 0H55XZZ
| Position | Character | Value | Definition |
|---|---|---|---|
| 1 | Section | 0 | Medical and Surgical |
| 2 | Body System | H | Skin and Breast |
| 3 | Root Operation | 5 | Destruction (Physical eradication of all or part of a body part by the direct use of energy, force, or a destructive agent) |
| 4 | Body Part | 5 | Skin, Chest |
| 5 | Approach | X | External (procedure performed directly on the skin surface without entry into a body cavity) |
| 6 | Device | Z | No Device |
| 7 | Qualifier | Z | No Qualifier |
PCS Root Operation: Destruction (5) vs. Excision (B)
- Use Destruction (5) when the lesion is physically eradicated in situ and no tissue specimen is retrieved β correct for cryotherapy, electrodesiccation, laser ablation, and chemical destruction
- Use Excision (B) when a portion of the skin or lesion is cut out and retrieved for pathology β this root operation does not align with CPT 17110βs clinical intent
- When multiple lesions at different body part sites are destroyed during the same session, assign a separate PCS code for each distinct body part β unlike CPTβs single-code approach for 1-14 lesions, PCS does not consolidate multiple body parts into one code line
π Coding Examples
Example 1 β Office: Cryotherapy for Multiple Plantar Warts
Clinical Scenario: A 29-year-old established female patient presents to her dermatologist with a 6-month history of painful plantar warts on the right foot. The provider documents 8 discrete verrucae plantaris on the plantar surface of the right foot, confirmed by clinical examination. The procedure note documents: βDestruction of 8 plantar warts, right foot plantar surface, using liquid nitrogen spray cryotherapy, 10-second single freeze cycle per lesion. Patient tolerated procedure well.β No separate, distinct E/M service is documented beyond the lesion-focused pre-procedure assessment.
| Field | Code | Rationale |
|---|---|---|
| CPT | 17110 | Destruction of 8 benign lesions (plantar warts); 8 lesions falls within the 1-14 range; cryosurgery is a covered destruction modality; plantar surface lesions are qualifying sites; reported once for the entire session |
| PDx | B07.0 | Plantar wart β most specific ICD-10-CM code available; documentation confirms plantar location and wart diagnosis |
Note
No separate E/M is billable here. The pre-procedure lesion evaluation and lesion count are bundled into 17110βs global payment. Modifier -25 would only apply to the E/M code if the provider separately documented a medically necessary evaluation addressing a distinct problem beyond the plantar wart management β for example, evaluation of a new foot wound or dermatosis entirely unrelated to the warts.
Example 2 β Office: Inflamed Seborrheic Keratoses with Separately Identifiable E/M, Modifier -25
Clinical Scenario: A 52-year-old established male patient presents to his primary care provider for scheduled follow-up of essential hypertension (well-controlled on lisinopril 10 mg). He mentions several irritated, bleeding skin lesions on his back and chest. The provider performs and separately documents a complete E/M service in a distinct note section: medication review, blood pressure assessment, updated problem list, and a care plan. In a separate procedure note, the provider documents destruction of 5 inflamed seborrheic keratoses β 3 on the upper back and 2 on the anterior chest β using liquid nitrogen cryotherapy with individual lesion identification documented. The E/M and procedure documentation are fully independent.
| Field | Code | Rationale |
|---|---|---|
| E/M | 99213--25 | Office visit, established patient; modifier -25 applied to the E/M code to indicate a significant, separately identifiable service (hypertension management) documented independently of the lesion destruction; -25 belongs on the E/M code, never on 17110 |
| CPT | 17110 | Destruction of 5 inflamed seborrheic keratoses; 5 lesions falls within the 1-14 range; cryosurgery documented; lesion type (inflamed seborrheic keratosis) and locations (back and chest) explicitly stated |
| PDx | L82.0 | Inflamed seborrhoeic keratosis β most specific code; provider documentation explicitly states βinflamed, bleedingβ keratoses; L82.0 supports medical necessity and is preferred over L82.1 |
| SDx | I10 | Essential (primary) hypertension β secondary diagnosis driving the separately identifiable E/M; supports the -25 modifier justification |
Warning
Modifier -25** must be appended to the E/M code only (99213-25) β never to 17110. Placing -25 on the surgical procedure code is clinically incorrect and will generate a denial. The E/M documentation must be entirely independent of the procedure note β auditors will deny the E/M payment if the only documentation is a pre-procedure lesion count that is inseparable from the destruction workflow.
Example 3 β Office: High Lesion Count Escalates to 17111, Comorbidity-Driven E/M
Clinical Scenario: An 8-year-old male with documented atopic dermatitis is brought to the pediatric dermatologist with widespread molluscum contagiosum. The provider counts and documents 22 discrete molluscum lesions on the trunk and bilateral upper extremities. Under topical EMLA anesthetic (applied 45 minutes prior), the provider destroys all 22 lesions via sharp curettement. The procedure note documents: βDestruction of 22 molluscum contagiosum lesions, trunk and bilateral upper extremities, via sharp curettement under topical anesthesia. 22 lesions treated this session.β The provider also separately evaluates an atopic dermatitis flare in an independent note section and writes a new prescription for triamcinolone cream.
| Field | Code | Rationale |
|---|---|---|
| E/M | 99213--25 | Office visit, established patient; -25 on E/M for atopic dermatitis flare management β separately and completely documented; independent of the molluscum destruction note |
| CPT | 17111 | Destruction of 22 molluscum contagiosum lesions; 22 lesions exceeds the 14-lesion threshold β 17111 (15 or more lesions) is the correct code; 17110 would be incorrect here; report 17111 once for the session |
| PDx | B08.1 | Molluscum contagiosum β confirmed viral etiology; lesion count (22) is the direct driver of the escalation from 17110 to 17111 |
| SDx | L20.9 | Atopic dermatitis, unspecified β secondary diagnosis supporting the separately identifiable E/M; atopic dermatitis is a recognized risk factor for widespread molluscum dissemination |
Note
Global period reminder: 17111 carries the same 010 (10-day) global period as 17110. All wound checks and lesion recurrence visits within 10 days of this session are bundled. If the patient returns within that window for the atopic dermatitis flare alone, append modifier -24 to the E/M code and document explicitly that the visit is unrelated to the molluscum destruction session.
β οΈ Common Coding Pitfalls
-
Billing 17110 for skin tag removal: Skin tags are explicitly excluded from the 17110/17111 family and must be reported under 11200-11201. Providers frequently use βbenign lesion destructionβ language for skin tag removal in procedure notes, but it is the lesion type, not the modality, that determines the correct code family. A claim for 17110 where the only supporting diagnosis is a skin tag code will generate a coding mismatch and denial.
-
Billing 17110 for actinic keratosis (AK) destruction: Actinic keratoses are premalignant, not benign, and are reported under 17000 (first lesion) + 17003 (each additional lesion, 2-14) β not 17110. This is a common compliance error; confirm the diagnosis β L57.0 (actinic keratosis) routes to the 17000/17003 family; B07.x and L82.x route to 17110.
-
Billing two units or two lines of 17110 for more than 14 lesions: 17110 is reported once for any session involving 1-14 qualifying benign lesions and is never billed as 2 units to capture additional lesions above 14. When the lesion count reaches 15 or more, the correct code is 17111 β reported once, regardless of the total above 15. Billing 17110 Γ 2 units triggers NCCI edits and constitutes a billing error.
-
Failing to document the exact lesion count: 17110 and 17111 are differentiated entirely by lesion count. If the procedure note states only βmultiple warts treatedβ without a specific number, the claim is underdocumented and vulnerable on audit. The note must state the exact number of lesions destroyed. If the count is absent or estimated, a provider query or addendum is required before coding.
-
Applying RT, LT, or modifier -50 to 17110: 17110 has a bilateral indicator of 2 β the bilateral adjustment concept does not apply. The code captures all lesions treated in one session across the entire body surface. Appending RT, LT, or -50 to 17110 is incorrect, will generate a claim edit, and signals a misunderstanding of this codeβs session-based structure.
-
Billing a related E/M within the 10-day global window without modifier -24: 17110 carries a 010 (10-day) global period. Any visit within that window for post-procedure wound checks, blister management, or lesion follow-up is bundled. Billing 99211-99215 without modifier -24 (and without documentation of an unrelated condition) creates an improper duplicate payment and is a common compliance finding in dermatology and primary care audits. Flag all 17110 procedure dates and block related billing for 10 calendar days.
-
Reporting 17110 for cosmetic lesion removal without medical necessity documentation: Medicare and most commercial payers consider seborrheic keratosis removal cosmetic unless documentation supports a clinical indication (bleeding, irritation, suspected malignancy). Billing 17110 with L82.1 alone, without a documented clinical reason for treatment, is likely to result in denial or recoupment. Verify that the procedure note contains specific medical necessity language before submitting the claim.
π Sources
1 AMA CPT 2025 Professional Edition β Surgery: Integumentary System, Destruction, pp. 117-120 Β· 2 CMS Calendar Year 2025 Medicare Physician Fee Schedule Final Rule (CMS-1807-F) β Relative Value Units and Global Period for CPT 17110 Β· 3 CMS RVU25A Physician Fee Schedule Relative Value Files β Work, Practice Expense, and Malpractice RVU Components Β· 4 NCCI Policy Manual for Medicare Services, Chapter 3 (Integumentary System), CMS 2025-2026 Β· 5 ICD-10-CM Official Guidelines for Coding and Reporting, FY2025 β Section I.C.1 (Infectious and Parasitic Diseases) Β· 6 ICD-10-PCS Official Guidelines for Coding and Reporting, FY2025 β Section B3 (Root Operation Selection: Destruction vs. Excision) Β· 7 CMS Medicare Coverage Database β Billing and Coding: Removal of Benign Skin Lesions, Article ID A57482 (rev. December 2023) Β· 8 AAPC β Dermatology Coding Alert: Benign Lesion Destruction, Lesion Count Documentation, and the 17110/17111 Threshold (2024) Β· 9 Experity Health β Correct CPT Code for Plantar Warts Claims (January 2026) Β· 10 Palmetto GBA Jurisdiction M Part B β Bilateral Procedures and Modifiers Policy (December 2024)
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