Wiki Coding for removal of Hymenal tag

[ljhaley@gmail.com]

Hi everyone!

This is a first for our office- we need to find a CPT for removal of a tag on the hymen, to be done in office. We're told code 56720 used to be used, but is now removed from 2010 books- any suggestions out there? Thank you!

 

[preserene]

First of all what is the documented diagnosis- intact hymen or rigid hymen, imperforate hymen and the tag is sitting on it or a redundant tag of an old torn hymen(which is the common reason for the tag) or any growth or infection?
Secondly, what is the intended procedure just the tag excision or Hymenotomy/Hymenectomy / partial or total or there was not a need for it or just a revision.
I think this has to be helped up with your diagnosis code.
For CPT there are 3 codes 56442, 56700; OR if not disturbing the hymen and just the tag alone then, 56501- if a destruction of the lesion would just do with simple cautery, electro cautery, cryocautery, chemosurgery because it can be considered as Interoitus and vulval procedure.
If it is a tag of an old tear then V code is to reported too.
The full pertinent an detailed documentation is very important for a procedure on a delicate issue like this because presence of hymen is there or not, could still be a medicolegal issue which is to be handled with care for a procedure and coding.

 

[kellyfrank]

We have redundant hymenal ring tissue and are excising in office with scissors. Insurance denies 56700 as not done in place of service 11. What other code can we use?

 

[nielynco]

We have redundant hymenal ring tissue and are excising in office with scissors. Insurance denies 56700 as not done in place of service 11. What other code can we use?

Sounds more like the work involved with 56442 instead of 56700.