Brief Guide to CPT Code 17110

Many dermatology and surgical clinics face challenges in understanding the complex rules of lesion removal coding, which can result in denials and lost revenue. That’s why we’re here to simplify it for you. With the right guidance, you can easily distinguish between simple removals and destruction codes to ensure accurate, compliant billing.

This guide is dedicated to discussing an essential procedural code, CPT code 17110. We will cover everything, from explaining its descriptor to billing and reimbursement guidelines.

If you are completely new to this system, check out our complete guide to CPT codes to get familiar with the basics.

So, without further ado, let’s get started.

17110 CPT Code Description

CPT code 17110 covers the destruction of benign lesions (e.g., warts, molluscum) using methods like cryosurgery or electrosurgery. This code is used when a provider destroys any quantity from 1 up to 14 lesions in a single session. It specifically excludes skin tags and certain vascular proliferative lesions.

Scenarios Where CPT Code 17110 is Applicable

Discussed below are some of the real-world clinical scenarios where CPT code 17110 applies:

Treatment of Multiple Molluscum Contagiosum

Picture a 6-year-old child presenting to the pediatrician or dermatologist with twelve scattered, characteristic lesions of Molluscum Contagiosum (a benign, viral skin infection). The provider elects to treat all twelve lesions using cryotherapy (freezing with liquid nitrogen) in a single session. Since Molluscum Contagiosum is a benign lesion and the quantity is within the 1-14 range, CPT code 17110 applies.

Destruction of Common Warts (Verruca Vulgaris)

Assume a 32-year-old patient visits the clinic complaining of several common warts (Verruca Vulgaris) on their hands and fingers. The physician diagnoses seven separate warts and destroys them all using electrosurgery. Warts are benign epidermal lesions and qualify for destruction under this code. Because the number of lesions (7) is less than 15, CPT code 17110 will be reported for accurate reimbursement.

Multiple Seborrheic Keratoses (SKs)

Imagine a 70-year-old male patient comes for a skin check, and the dermatologist identifies six symptomatic or irritated Seborrheic Keratoses (benign brown, warty spots) on his back and chest. The physician destroys these six lesions via curettage and electrodesiccation. Seborrheic Keratoses are common benign lesions. The technique (destruction) and the quantity (6) mandate the use of CPT code 17110.

Applicable Modifiers for CPT Code 17110

What happens when you encounter a situation where the destruction is performed on the same day as a separate, distinct procedure? Reporting CPT 17110 without a proper modifier may be identified as a duplicate claim or be improperly bundled.

Here are the essential modifiers to know:

• Modifier 25 (Significant, Separately Identifiable Evaluation and Management Service): This is commonly used. If the destruction procedure (17110) occurs on the same day as an unrelated or significant E/M visit (e.g., CPT 99213) to diagnose a new issue, Modifier 25 is appended to the E/M code. This tells the payer that the visit was medically necessary and distinct from the scheduled procedure.
• Modifier 59 (Distinct Procedural Service): This one is crucial. Use this when the destruction service (17110) is performed concurrently with another procedure that normally would be bundled, but in this specific instance, the services are considered separate and distinct. This is similar to how modifiers clarify separate services in other domains, like therapeutic exercises captured by CPT code 97110.
• Modifier 54 (Surgical Care Only): Less common, but used if the surgeon performs the procedure but the follow-up care is transferred to another physician.
• Modifier 55 (Postoperative Management Only): Used by the physician who handles the patient’s follow-up care after another provider performed the initial procedure.

For detailed guidelines on proper usage, consult authoritative coding resources from organizations like the American Academy of Dermatology (AAD).

CPT Code 17110 – Billing & Reimbursement Guidelines

The following are the essential reimbursement and billing requirements for the destruction of benign lesions:

Demonstrate Medical Necessity

The payer will never compensate for care services if the procedure is deemed medically unnecessary. The top requirement is to justify why the destruction was necessary. For benign lesions, medical necessity is often met if the lesion is:

• Symptomatic (painful, bleeding, itching).
• Clinically infected.
• Irritated by clothing or friction (due to location).
• Necessary for diagnosis (e.g., to rule out malignancy).

If the reason for removal is purely cosmetic, the payer will deny the claim, and the patient may be billed directly.

Ensure Detailed Documentation

Comprehensive and accurate documentation is another integral requirement when billing CPT code 17110. It also helps in demonstrating medical necessity. Therefore, your documentation must include the following:

• Location and Diagnosis: Clearly state the diagnosis (e.g., Verruca Vulgaris).
• Quantity: Explicitly list the exact number of lesions destroyed.
• Technique: State the method of destruction used (e.g., cryosurgery, electrodesiccation).
• Medical Necessity: Document the patient’s symptoms or why the removal was clinically indicated (e.g., “patient reporting constant irritation from waistband”).

Correct Coding for Quantity

Always remember the quantity cutoff:

• 1 to 14 lesions: Report CPT 17110.
• 15 or more lesions: Report CPT 17111.

Do not bill CPT 17110 multiple times to cover 15 or more lesions. Using the incorrect code for the quantity will result in denials due to bundling.

Conclusion

We have covered a lot of ground in this comprehensive guide. So, let’s quickly summarize all key takeaways to reiterate all the critical details related to CPT code 17110.

• First, we explained that CPT 17110 covers the destruction of 1 to 14 qualifying benign lesions (excluding skin tags and vascular lesions) by any method.
• Next, we shared clinical scenarios where this CPT code applies, including the destruction of Molluscum Contagiosum, common warts, and irritated Seborrheic Keratoses.
• We emphasized the use of Modifier 25 when performed with a separate E/M visit.
• Finally, we discussed the billing guidelines, stressing the need for clear documentation of the quantity and medical necessity (i.e., not cosmetic).

With all this information, you are now equipped to navigate the precise coding for benign lesion destruction and secure timely reimbursement for your dermatological procedures.