Orthopedic Coding Alert

Determine the location, depth, and size to select the right code. When reporting lipoma excisions, don't automatically code these services using tumor codes as a lipoma is a benign lesion consisting of fatty tissue. For example, if your surgeon excises a 3 cm lipoma in the sacral region, you will be wrong if you report 49215 (Excision of presacral or sacrococcygeal tumor). This code is typically for tumors that lie at the base of the spine; these do not usually arise from the fatty tissue. "Reporting 49215 would be a misrepresentation of the work value of the service to report removal of a subcutaneous lipoma," says Kristi Stumpf, MCS-P, CPC, COSC, ACS-OR, owner, Precision Auditing and Coding, senior orthopedic coder & auditor, The Coding Network, Washington. "Code 49125 appears to be a more extensive procedure including resection of the presacral or sacroccygeal tumor," says Elizabeth Kenney, CPC-A, Department of Orthopaedics, [...]