17110 CPT Code: Description, Billing Guidelines, and Reimbursement

What Is CPT Code 17110?

The American Medical Association (AMA) defines CPT code 17110 as the destruction of benign lesions (such as warts, molluscum contagiosum or seborrhoeic keratosis) including up to 14 lesions, other than skin tags or cutaneous vascular proliferative lesions.

CPT 17110 key facts:

Depending on the lesion and clinical circumstances, destruction may involve cryosurgery, electrosurgery, laser surgery, chemical treatment, or surgical curettage.

Common Conditions Treated under CPT 17110

• You report 17110. You murder non-cancerous growths on your skin that do not need to be cut or shaved off. Commonly diagnosed areas of the body:
• Common, plantar, or flat warts are caused by Human Papillomavirus (HPV).
• Molluscum contagiosum: Small firm skin infections caused by a virus.
• Seborrhoeic Keratosis: Non-cancerous growths that become inflamed, painful or irritated.
• Nevi, Acquired or Congenital: Non-cancerous moles removed by non-excisional methods.

Preparing for the CPT 17110 and Related Lesion Codes: Don't make costly mistakes

Removing miscoded lesions is a quick route to the clearinghouse denials and payer audits. Here’s a breakdown of CPT 17110 and similar codes to help your team select the right code every time.

Critical Code Exclusions

• DO NOT code 17111 (1 unit) with 17110 (2 units): If the provider sees 16 warts in one office visit, only code 17111 (1 unit). You cannot bill 17110 for the first 14 and 17111 for the remainder.
• Do not code 17110 for skin tags. Code 11200 (up to 15) and 11201 (each additional 10) for each skin tag.
• Do not use 17110 for premalignant/malignant lesions; use 17000/17003 for pre-cancerous growths such as actinic keratosis. Malignant lesions are coded to codes 17260–17286 or excision codes.

Essential Billing Guidelines for CPT Code 17110

You must follow several CMS and commercial payer rules to successfully bill 17110. One small mistake in the billing, and it's a rejection.

1. Correct Unit Reporting

• CPT 17110 is used for the entire encounter for up to 14 lesions.
• Treating 1 lesion = 1 unit of 17110.
• 17110 is 1 unit to treat 8 lesions.

Any claim(s) with a claim form for $17110 billed for more than one will be denied.

2. Proving Medical Necessity

Commercial payers and Medicare Local Coverage Determinations (LCDs) not only refuse to cover cosmetic removals, but they also prohibit the removal of cosmetic lesions. CMS Billing and Coding Guidelines (A54602) indicate that the removal of benign skin lesions is deemed medically necessary when the patient presents clear clinical signs.

• Skin may become rough, sore, itchy, or bleed.
• Pus, characterised by oozing, swelling, or inflammation, indicates the presence of an infection.
• Nasal congestion or loss of vision.
• Lesions resulting from persistent friction or contact with clothing.
• Malignancy should be ruled out in cases of clinical uncertainty.
• If a patient requests the removal of a non-irritated wart or mole for cosmetic purposes, bill the service directly to the patient using ICD-10 Z41.1 for Encounter for cosmetic surgery. Additionally, provide an Advance Beneficiary Notice (ABN) to all Medicare beneficiaries.

3. Correct ICD-10 Code Pairing

It’s the use of a generic or unsupported diagnosis code that prevents a CPT 17110 from auto-adjudicating. Some of the common ICD-10 codes are

• B07. Plantar wart
• Other and unspecified viral warts B07.8 / B07.9
• B08.1 Molluscum contagiosum
• The lesion is an inflamed seborrhoeic keratosis (L82.1).

How to Use Modifiers with CPT 17110

Correct modifier use ensures clean reimbursement when multiple procedures or office visits are performed on the same day.

Establishing Modifier Needs

Consider whether CPT 17110 required a modifier based on whether the visit included an Evaluation and Management (E/M) service or another procedure:

1. Bill one CPT 17110 unit for independent work. Modifiers are unnecessary.
2. E/M services during the same visit:
   • E/M codes should include Modifier 25 if the service is separate.
   • 17110 covers E/M services with routine pre-procedure monitoring. Do not bill E/M separately.

Modifier 25 (Significant, Separately Identifiable E & M)

You can’t charge an Evaluation and Management (E/M) code (99202-99215) when you see a patient for a scheduled lesion removal. 17110 includes the pre-procedure consultation fee.

If the patient is having a full medical exam (i.e., management of hypertension or evaluation of a new rash) and the provider decides to treat 3 painful warts during the same visit, the E/M code may be billed with modifier 25 appended.

Modifier 59

It indicates that a procedure or service was separate from other services provided on the same day. This modifier means that the procedure was not bundled with another service. Needed for proper coding and billing.

If the provider performs another non-E/M procedure, distinct from the benign lesion destruction, append modifier 59 (or X-modifiers such as XS) for the same session.

The provider did a biopsy of a suspicious mole on the left arm (CPT 11102) and treated 4 viral warts on the right leg (CPT 17110). If multiple anatomic sites are separately reported, append Modifier 59 to the code with the lower relative value or per National Correct Coding Initiative (NCCI) edit rules.

17110 CPT Code Reimbursement Rates and RVUs

CPT 17110 reimbursement is based on the setting (facility vs. non-facility), regional Medicare Administrative Contractor (MAC) locality adjustments and the private payer contract terms.

According to the CMS Physician Fee Schedule, the relative value units and average national rates break down as follows:

Average Commercial Payer Payment: $85.00 - $130.00

Global Period Guidelines

CPT 17110 has a 10-day global period. The payment contains:

• The procedure itself.
• Local anaesthetic agents (eg topical or local infiltration)
• Follow up visits within 10 days for recovery or wound healing. Post-procedure care is routine.

You will get a denial if you try to bill a separate office evaluation for routine post care within 10 days post-op.

Complete Clinical Documentation Requirements

If an insurer selects a claim with CPT code 17110 for audit, the clinical records must clearly document all of the elements of that code. Clinicians should record:

• Anatomical Locations: Describe body surfaces (e.g., “3 on right anterior thigh, 3 on left forearm”).
• How it was destroyed: (e.g., “cryotherapy with liquid nitrogen (two freeze-thaw cycles of 15 seconds each)”)
• Medical Necessity: Document patient complaint (i.e., lesions are sticking to clothing, bleeding and causing some pain (4/10)).
• Post Procedure Instructions: The patient was instructed in wound care.

Frequently Asked Questions (FAQs).