Internal Medicine Coding Alert
Xanthelasma of the Eyelid
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Question: A patient was treated with liquid nitrogen for xanthelasma of the eyelid. The patient did not have hypercholesterolemia and was on no medication for cholesterol control. What ICD-9 code should be used? Code 272.2 (mixed hyperlipidemia) doesnt seem appropriate. Code 374.51 requires an underlying condition, and the patient doesnt have one.
Alice Cordell
Shady Grove, Pa.
Answer: Xanthelasma is a fatty tumor of the eyelid, which is linked to high fat content of the blood, according to Felecia Bernstein, CPC, EMT, an independent coding consultant. ICD-9 coding requires that an underlying condition of ICD-9 272.0-272.9 (disorders of lipoid metabolism) be reported as the primary diagnosis. In this case, 272.2 would be appropriate to report first. Code 374.51 (xanthelasma) should be reported second.
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