Wiki Atrophic scar excision

[RebeccaMoney]

Needing help with CPT(s). Removal hardware;excise scar;excise mass.
Attention was turned to the ulnar border of the forearm with a previous surgical incision was identified. It was noted to be a widened atrophic scar that was excised. The intramuscular plane was identified. One remaining screw was noted, but it was noted to be deep inside the bone so it was left in. The palpable mass was identified and noted to be consistent with a rent in the fascia. Attention then turned to other areas of scar tissue where thickened, atrophic scar was excised. Deep tissue were closed.

I see that the hardware was left so I can't bill for that. Can't figure out what CPT for the scar exicision and mass excision. I'm looking at 25076 for the mass excision but what about the scars ( I think 2 were excised). Thank you,

 

[svms]

I have coded scar revisions in the past. I would use 13120-13122 depending on the size of the excision.

 

[mitchellde]

I have coded scar revisions in the past. I would use 13120-13122 depending on the size of the excision.

I do not see a mass excision in this documentation, only that it was noted to be a rent in the fascia. Also scar excisions are to be coded as benign lesion excision per the CPT assistant, and you will need size and location documented.