04/12/2022

Emblem Health Denial for CPT 17110

Emblem Health has recently been denying claims for 17110, viral warts, stating it is considered cosmetic. I reviewed on the Emblem Health / HIP website that this was a policy change and the code will be cosmetic unless patient has psoriasis. This is the only code I know of to use for the treatment of viral warts. Is there a new code I can use?

Emblem Health follows Medicare guidelines with wart removals- the procedure is covered, but a specific diagnosis code must be billed in order for the minor procedure to be covered. If one of the two diagnosis codes are used, the procedure will be paid by Emblem and will not be denied as cosmetic:

• B07.0 (plantar wart)
• B07.8 (other viral warts)

If a claim is billed with DX B07.9 (viral warts, unspecified), the charge will be denied as not medically necessary. If the claim was billed with this diagnosis, it should be corrected if the documentation supports the corrected claim. It is recommended to bill a secondary diagnosis with the wart removal, such as pain of the toes or foot, depending on the location of the lesion.