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  • Hey TJ,
    My last day at this assignment is tomorrow. Have a couple of other assignments lined up that will take me into the new year. Hope all is with you.
    Hi. I'm really new to this, but the closest HCPCs code I find is A4300 Implantable access catheter, external access. Are you from Sanford Brown too?
    Hey TJ,
    I'm doing fine. Work continues to be a little strange because of all of the changes going on. I'm figuring by end of year I'll be on a new job. How about you? What's happening with your facilities?
    Hey TJ,
    Good to hear from you. I'm doing fine, though there are some big changes taking place at the ASC I code for. They're looking to de-centralize their coding/billing department, so as a consulting coder I'll probably be out of here by the end of the year. How are things with you? Less dramatic then here I hope.
    Best,
    David
    Hi TJ,

    Regarding neurostimlators and pain pump, I'll send you an email this evening with some information.
    Best,
    David
    Hey TJ,
    Sounds like you were having technology problems. Computers can be a real pain, but we wouldn't get far without them in our line of work. Do you work for a multi-specialty ASC?
    No problem, see if this will help. There are three layers of integumentary, the epidermis or outerlayer ( think of it as a protective shield), the dermis which is the true skin, and the subcutaneous the layer just under the true skin.
    Morning,
    I had a chance to look at your post and in my opinion the 11400 codes would be appropriate--the cyst, even though ruptured, is a skin lesion. Having said that, there are some inclusion cysts that are subcutaneous as well. Also, 706.2 is the correct code for an inclusion cyst.

    The issue with subcutaneous has to do with depth. You may actually run into a situation where an inclusion cyst might support using 21555. If you have access to CPT Assistant, take a look at August 2000 Review of Integumentary Excisions of Lesion Codes and August 2006 Coding Communications Questions and Answers. There is some good information there.

    If you are able, set up a system where you can query the doctor when the information in the op report seems unclear I would do that. We send queries to the doctors regularly regarding lesions exicisions. Just remember, you're in good company--lots of us have run into the same question regarding which code to use.

    Hope this helps
    Best ,
    David
    Hi, for some reason the message you wrote I can read it if I go to your profile but not in mine.
    So anyway, your welcome and I'm glad you understand because sometimes I'm not good at explaining things.
    Thanks for your info in case I have a question.
    thank you so much, explaing the lipoma IT makes since now, thanks inclusion cyst as integumentary , I completely understand now, thanks for your help

    TJ HARDY
    ASC LLC
    504-349-2498,
    504-349-6495 FAX NEW ORLEANS, LA

    F you ever need help or can have good info on coding dont hesitate to give me a call or fax either way or email
    tjhardy1966@bellsouth.net thanks again
    Hello,
    Well what I was taught is you always code from the path report, and this was, from what you said, an epidermal inclusion cyst which is dx 706.2 and that dx does not go with 21555. Also, this wasn't a very big mass or a wide excision or a reexcision so I would go with the integumentary section on this due to all those factors. Just make sure you bill for the closure as well because if you read the description for an intermediate closure it is for closures in deep subcutaneous tissue.
    If this turned out to be a lipoma then you could code this as 21555, but it was just an inclusion cyst. Just because it went to subq tissue doesnt mean it is always in the muscular skeletal section.
    I hope I explained well.
    If you ever have any other questions don't hesitate to ask.
    :)
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