1. E

    Question Excision of Genital Warts

    Op Report Procedure: Wide local excision of genital warts Findings: Multiple genital warts, some were very thickened with wide bases, not amenable to laser or treatment with TCA or cryotherapy. Very large 2X2 thickened warts in the perineum, one on the left and one on the right. Other, smaller...
  2. E

    Question Excision of Condylomata/skin tag

    The patient presents for complaint of lesions. The provider documents 1 skin tag on the glute, and 2 skin tag/ or Condylomata on the labia, 1-2 mm, and a vaginal polyp. If the provider moves forward with excision of all 3 lesions and the polyp removal, what CPT codes should be expected? I'm...
  3. M

    Question Advice for excision of deep forehead mass

    The doctor removed a forehead mass that went to the skull and complex multilayer closure. The codes I found for forehead mass are 21011-21014 but none of those codes involve the bone. I also looked at code 11420. The doctor is waiting for the pathology report but he believes it might be a...
  4. K

    Question Metatarsal Bone Excision

    Patient had a partial excision of the metatarsal bone years ago. Now patient is having the remaining metatarsal excised. I was thinking 28140 since the remainder of the bone is being completely excised. My physician is thinking 28122 since the patient previously had a partial excision of the...
  5. J

    Questions on coding procedures

    Thank you in advance! I have a couple of questions related to procedure coding for dermatology. If anyone is able to answer these, it would be greatly appreciated! 1. For scar revision after an excision of malignant lesion due to the scar not healing properly, is a benign excision also billed...
  6. V

    Partial breast excision

    Our patient has symmastia (congenital malformation of breasts, uniboob). We want to do a partial breast excision. What coding would be best used to describe this procedure? Thank you!
  7. S

    Trigger Finger Release w/ Excision Dupuytren's Nodule

    How would you code a trigger finger release with excision of dupuytren's nodule? #1 - 26160, 26055-59? #2 - 26123? The tourniquet was inflated to 200 mmHg and a 2cm bruner incision over the A1 pulley of the left ring finger and proximally over the dupuytrens disease. Starting proximally we...
  8. J

    ENT coding: nasopharyngeal mass excision via scope

    A surgeon is disputing our procedural coding on the following operation. I'd like to check our work and if correct, find some official source that may help explain to him why we've chosen the code we did. We selected 30999 unlisted procedure, nose because there is no code describing a nasal mass...
  9. J

    CPT code for excision of subQ venous malformation in forearm?

    One of my providers had a patient w/ a lump on her forearm that was tender, blue, and had gone from compressible to non-compressible. His differential dx was "cyst vs. vericosity with thrombus". The decision was made for excision. Here is the procedure note: "After discussion of the...
  10. K


    Hi! I work at a Dermatology office as their Coding Specialist. I'm posting a charge for an excision of a Lipoma with the code 27618. My co-worker seems to think an intermediate repair is included in this code? But I was going to post a charge for 12032. I can't find the guidelines on whether...
  11. Y

    Help CPT Assignment of 49204

    Hello, We were wondering what CPT you would assign, with the following description of procedure. DESCRIPTION OF PROCEDURE: Dr. Gyn attention was then turned to the patient's abdomen and a 5 mm infraumbilical incision was made with a scalpel. The 5-mm trocar and scope were inserted in this...
  12. A

    Diagnostic or Therapeutic Wedge

    I am not very confident in this part of my coding and I want to make sure I am coding this correctly. The op note is below and I want to code it wit 32608: :confused::confused: History of an abdominal GIST tumor s/p resection a few years ago. As part of her monitoring she was found to have a...
  13. B

    Help! 21026

    Need help with this in office procedure note. :confused: Provider is billing 21026/22 but this seems too invasive for an office setting... Also, if we were excising bone it would seem we would give more than local anesthetic. The provider used local anesthesia 1% Lidocaine and .25% Marcaine...
  14. J

    Billing a new pt visit and excision

    The patient's only reason for the visit was for her mass. I am hesitant to bill the E/M with a 59 as there was nothing else addressed. The doctor coded a 99202 and a 27327 both with the same diagnosis of D17.9 I am new to surgical/procedural billing and coding Do I only bill the excision...
  15. D

    Excision of mass with closure/ complex repair

    The billing comes over marked 21933, 13101/59, 13102/59. A mass was removed the patient's flank, fine, but the surgeon has underlined this in the chart: A direct approximation of closure was not possible without creating significant additional deformity. Extensive undermining of skin and...
  16. S

    More clarification of 19301 vs 19125

    I am looking at multiple op reports where there is needle localization, clearly documented in the op report and a radiologist report, where the surgeon does a "deep dissection" around the needle/wire and completely excises the tissue and wire and it is sent to radiology for confirmation that...
  17. R

    Excision of right groin seroma - CPT code?

    Excision of right groin seroma with flap - CPT code? Hello, can anyone please help with finding a code for: Excision of right groin seroma with satorius flap Thank you for your help.
  18. R

    Chondroplasty PCS- repair or excision?

    Hello everyone! I am taking the General PCS code set online program and one of my practice questions is a chondroplasty. I read through the report and selected the root operation "excision". But my answer sheet coded it to "repair". Can anyone explain how and where I went wrong with my...
  19. S

    Nerve Excision x's3

    Hi all, My General Surgeon says he removed 3 nerve bundles and to code 64795 x's3. Here is his op report: Local Anesthesia. A 5cm incision was made over the site of previous trigger point injections. A 7x5cm area of anterior abdominal wall was then exposed up to the midline medially and 2cms...
  20. S


    We recently added a dermatologist to our practice and he insisted that we can bill an office visit 99213 and excision for the same day with the same diagnosis code...I believe that's not right ...Please help
  21. R

    physician coding-down coding?

    Hi. the orthopedic physician excised a bone lesion of the tibia and closed it with an allograft-27638. per coding guidelines you can only code for the allograft as the excision is inclusive. He wants to code for an excision w/ a biopsy to get higher RVUs-27635 and 20245 instead. Is this...
  22. T

    Medicare Denial of 88305

    We are a dermatology office whose doctor is a certified dermatopathologist as well. He can perform MOHS. We have come across a new issue with Medicare when billing MOHS and a separate pathology on the same day. Here is an example: Patient comes in and has MOHS done on the arm by the doctor. The...
  23. A

    Excsion of 5 cm spurtrophus and excision of bursa from olecranon

    The surgeon removed a 5 cm spurtrophus and an excision of bursa from the olecranon. I am thinking that it should be coded with 24105 and 24073. What do others think? We are having a difference of option in our office on this one. Please help! Can't find anything relating to this anywhere!
  24. A

    Coding for excision of olecranon spurtrophus and bursa

    The surgeon removed a 5 cm spurtrophus and an excision of bursa from the olecranon. I am thinking that it should be coded with 24105 and 24073. What do others think? We are having a difference of option in our office on this one.
  25. F

    Excision giant cell tumor of bone

    Please help! Patient diagnosed with giant cell tumor of bone. I need help with CPTs for: 1. Excision of extraosseous mass, left shoulder 2. Curettage and bone grafting of left acromion plus cement injection into the left acromion Thank you! Tobi C., CPC
  26. C

    Excision Gouty Tophi Fingers

    Need some help with the CPT code for this procedure Excision of gouty tophi, thumb, index finger and long finger Incision extended from distal to DIP joints, involving dorsal and volar aspects. Thanks to all, Carol
  27. P

    unclear pathology terminology to code excision

    I am coding an excision of lesion on thigh that was on hold for pathology [CPT 12032, 11402]. The path result diagnosis came back as "atypical compound melanocytic nevus". I would code this as dx 216.7 (benign neoplasm, thigh) - however, the pathology states additionally "the findings are...
  28. M

    Second opinion.... Back mass excision

    Procedure: The patient was brought to the operating room and placed in the supine position. With appropriate monitoring, she was induced with general anesthesia without complication. She was then turned on her side and the area was painted with Betadine and draped in a sterile fashion. An...
  29. Skinne

    Integumentary Coding Question

    I am not sure if I have interpreted this correctly. In the Integumentary section of the CPT book under excision of benign or malignant lesions (page 53 or 54 of the 2007 book), it says that if a closure requires an intermediate or complex closure, you need to report the excision in addition to...
  30. A

    help with shave biopsy please

    I need help with documentation that states shave biopsy... Then in the 2nd statement states two lesions removed with diameters. Physician coding removal of lesions. Please refresh me on why provider would state shave biopsy, a shave biopsy is different than excision of lesion. Excision of...