Skin tag removal CPT codes are 11200 and 11201. They will be reported for services when the physician performs skin tag removal using sharp excision with scissors or scalpel, electrical cautery, chemical cautery, ligature strangulation, or any combination of these methods.
Skin Tag Removal CPT Description
The skin tags are benign growths and frequently found around the neck, axilla, near the chin, around the eyelids, and under the regions of the breasts.
Skin tags are painless but can be irritating by applying pressure on them. There are several reasons for skin tags but not proven, such as Diabetic, overweight, and pregnant women are more likely to have skin tags.
They can vary in size, shape, and mostly skin color. Skin tags removals are mostly considered cosmetic procedures and may not be covered by the insurance.
CPT 11200 will be reported to remove the first 15 lessons, and each additional ten lesions will be reported with CPT 11201.
If lesions are benign, they will be reported with appropriate CPT codes (11400-11446) instead of CPT codes 11200 and 11201.
CPT 11200 will be reported when removal of skin tags, multiple fibro cutaneous tags, and any area performed by the physician, including up to 15 lesions.
CPT 11201 will be reported when removal of skin tags, multiple fibro cutaneous tags, any area is performed by the physician for each additional ten lesions in conjunction with primary procedure code 11200 (up to 15 lesions)
Skin Tag Removal CPT Modifiers
The following is the list of modifiers for CPT codes 11200 and 11201:
- 22, 23, 47, 51 52, 53, 58, 59, 63, 73, 74, 76, 77, 78, 79, 99, AI, AQ, AR, CC, CR, EY, ET, Q5, Q6, QJ, SG, XE, XU, XP, XE, XS, GA, GC, GJ, GK, GR, GU, GY, GZ, KX, and PT.
Modifier GY will be attached to CPT code 11201 if the patient request cosmetic service to indicate that the service does not cover by Medicare.
Modifier 23 is applicable with CPT codes 11200 and 11201 if general or local anesthesia is given to patients, which are normally not required for the procedure.
Modifier 22 can be applied to CPT 11200 and 11201 when physicians spend more time on complicated procedures than normal procedures.
Modifier 76 will be attached to CPT codes 11200 and 11201 if service is repeated by the same physician on the same date of service, while modifier 77 if the procedure has been done on the same date service by a different physician, respectively.
Modifier 78 will be appended with CPT codes 11200 and 11201 if the procedure is repeated with the same condition of the global period. In contrast, modifier 79 is applicable when the procedure is reported for an unrelated condition.
Modifier 59 is applicable with CPT codes 11200 and 11201. If any other procedure is done in combination with these services that are not normally billed together on the same date of service, then modifier 59 will be appropriate.
While modifier 51 is applicable when the other procedure is not the component of CPT 11200 and 11201
Modifier 53 will be reported with CPT codes 11200 and 11201 if the skin tag removal procedure is terminated due to unavoidable circumstances or unstable patient conditions.
In contrast, modifier 52 is applicable when the skin tag removal procedure is performed with full preparation but needs to terminate the procedure immediately and do not have the plan to redo the procedure in the future.
Modifier 52 will be appropriate with CPT 11200 and 11201.
It would be only payable if the patient is seen by the physician for unrelated conditions with modifier 25.
While modifier 24 is applicable with E/M code if the patient is seen for an untreated condition in the postoperative period.
Skin Tag Removal CPT Reimbursement
A maximum of 1 unit of CPT 11200 and 11201 can be billed on the same date of service, while 2 and 3 units can be billed when documentation supports the medical necessity of CPT 11200 and 11201.
The cost and RUVS of CPT 11200, when performed in the facility, will be $85.36 and 2.46674, respectively. At the same time, non-facility will be $103.66 and 2.99549.
The cost and RUVS of CPT 11201, when performed in the facility, will be $17.66 and 0.51045, respectively. At the same time, non-facility will be $20.10 and 0.58095.
Documentation should support the medical necessity of service and be medically appropriate. The appropriate ICD 10 codes should be reported to the claims for reimbursement.
The most billed dx codes are K64.4, Z41.1, L91.8, L91.9, N90.89, Q17.0, Q82.6, and Q82.8.
CPT codes (11200-11201) include Sharp excision or scissoring, Electrosurgical destruction, Chemical destruction, Electrocauterization, Ligature strangulation, with and without administration of anesthesia, and these services will not be reported separately.
Medicare does not pay separately for surgical trays (HCPCS code A4550) combined with CPT codes 11200 and 11201.
Therefore, check the appropriate payer guidelines of commercial insurances, or third parties may reimburse this service and report accordingly.
If excision of the benign lesion is performed, then it is appropriate to report with CPT codes 11400-11446 instead of CPT 11200 and 11201.
CPT codes 11200 and 11201 will be reported to remove skin tags by scissoring or any sharp method, electrosurgical, chemical, or electrocauterization of the wound destruction, ligature strangulation, or maybe combination technique used for treatment, which also includes chemical or electrocauterization of the wound.
CPT code 11200 has ten days (about one and a half weeks) global period.
If any Evaluation and management (E/M) service is performed in conjunction with CPT code 11201, then modifier 24 will be reported with E/M service for an unrelated condition.
For example, if the E/M visit is for postoperative care of prior surgical procedure, then it is not appropriate to report the E/M code with CPT code 11201 separately during the global period.
CPT code 11200 will be reported for the removal first 15 lesions, and every ten subsequent lesions will be reported with add-on CPT code 11201.
For instance, a Patient is presented to a physician for tag removal of up to 35 lesions. It would be reported like 11200 for the first 15 lesions, and two units of 11201 will be billed for the remaining 20 lesions 11200 (15 Lesions), 11201 (10 Lesions), 11201-59 (10 lesions).
There are the following examples of when CPT 11200 and 11201 will be billed:
A 36-year-old male presented to the office with morbidly obese weight and have multiple tags near the chin and shoulder region. The patient denies any itching or sensation on the tag’s sites.
He had around 30 tags around his chin and shoulder. The patient requested to remove all the skin tags.
Physical removes all his tags with sharp excision scissors. It would be billed as follows:
The first 15 lesion removal will be reported with CPT code 11200, and an additional ten lesions will be reported with add-on code 11201.
Another unit of 11201 will be billed with modifier 52 because only five lesions were removed out of 10. The insurance may not cover this service because tags were painless, and the patient had no itching.
A 26-year-old female presented to the office with multiple tags under the breast regions. The patient complains that these tags are painful and have itching in these regions.
The patient did apply some ointment to this region which was effective for 2 to 3 days. The patient denies any headache, numbness, dryness, dizziness, numbness, abdominal pain.
The physical exam revealed that the patient has swelling and redness under the breast region. The patient has around 15 tags under the breast region.
The physician decided to remove these tags with chemical destruction. The procedure was done successfully and tolerated well by the patient.
The 15 tags removal will be reported with CPT code 11201 only.
CPT Code For Vulvar Skin Tag Removal
The CPT code for vulvar skin tag removal is 56620 and 56625. These will be reported for vulvar skin tag removal instead of CPT code 11201 and 11201.
If the vulvar area is removed greater than 80%, it would be reported with 56625. while the vulvar area is removed less than 80%, it would be reported with 56620.
Removal Of 25 Skin Tags CPT Code
CPT code 11200 will be reported to remove skin tags of the first 15 lesions, and ten subsequent lesions will be reported with add-on CPT code 11201.
CPT code 11200 will be reported as a primary procedure code and 11201 as a secondary proceeding code. It would be like (11200, L98.9), (11201, L98.9).
Skin Tag Removal CPT Code 2018
If the lesion is benign, malignant, or other than skin tags or cutaneous vascular proliferative lesions will be reported with separate CPT codes 17106-17108, 17110, 17000-17004, 17111, 0419T, 04120T instead of CPT code 11200 and 11201.
CPT Code For Skin Tag Removal Cryotherapy
CPT 11200 and 11201 include skin tags removal by chemical destruction or Sharp excision or scissoring method.
Therefore, it would be reported with CPT codes 11200 and 11201.