I code for Urology, but I had an unusual case that my research directs me to derm, but I want to make sure I use the correct one.
Patient had a previous excision of a penile mass, which healed into fibrous scar tissue. Lesion recurred. Patient did not want to go thru the hassle of plastics, insisted on Urology. The doctor used a 15 blade to incise the skin then a Bovie to excise the fibrosis, scar, and lesion from subq tissue, totaling 3cm. He did two layers of sutures to close - 3-0 chromic horizontal mattress sutures to close subq and then 4-0 chromic to re-approximate the skin edges.
My colleague says 11423 would be appropriate because he excised a "mass".
My research points to the 13132 because of the layered suture.
BUT, it could go to the 12002 because it it's only subq.
If he had just excised the lesion, I would've gone with 54060, but once I saw scar tissue and multiple layers of sutures, I started thinking derm codes. But, as I said, derm isn't my forte, so I'm hoping someone with more familiarity than I will shed some insight.
Thanks in advance!!
Patient had a previous excision of a penile mass, which healed into fibrous scar tissue. Lesion recurred. Patient did not want to go thru the hassle of plastics, insisted on Urology. The doctor used a 15 blade to incise the skin then a Bovie to excise the fibrosis, scar, and lesion from subq tissue, totaling 3cm. He did two layers of sutures to close - 3-0 chromic horizontal mattress sutures to close subq and then 4-0 chromic to re-approximate the skin edges.
My colleague says 11423 would be appropriate because he excised a "mass".
My research points to the 13132 because of the layered suture.
BUT, it could go to the 12002 because it it's only subq.
If he had just excised the lesion, I would've gone with 54060, but once I saw scar tissue and multiple layers of sutures, I started thinking derm codes. But, as I said, derm isn't my forte, so I'm hoping someone with more familiarity than I will shed some insight.
Thanks in advance!!