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Wiki Coding removal of lipoma

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jwebb

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We have a claim where provider did not document any measurements when removing a mass which was down to the subcutaneous depth. The pathology stated masses were lipomas. A total of 14 were removed from each thigh area. How would we code the removal of these masses since the provider didn't supply measurements of any of these masses.
 
You can't without size.

There are soft-tissue excision codes by site, depth, and size.

27327 Excision, tumor, soft tissue of thigh or knee area, subcutaneous; less than 3 cm
27337 Excision, tumor, soft tissue of thigh or knee area, subcutaneous; 3 cm or greater

You also run into an MUE problem. MUE for these codes are 5 and 4 respectively.

Regardless, you'll have to submit notes to the carrier for the quantity. Perhaps you can get around the size documentation restriction this way.


Wondering if anyone else wants to chime in regarding defaulting to the lesser code if size isn't documented individually.
 
You can't without size.

There are soft-tissue excision codes by site, depth, and size.

27327 Excision, tumor, soft tissue of thigh or knee area, subcutaneous; less than 3 cm
27337 Excision, tumor, soft tissue of thigh or knee area, subcutaneous; 3 cm or greater

You also run into an MUE problem. MUE for these codes are 5 and 4 respectively.

Regardless, you'll have to submit notes to the carrier for the quantity. Perhaps you can get around the size documentation restriction this way.


Wondering if anyone else wants to chime in regarding defaulting to the lesser code if size isn't documented individually.[/QUOTE]


Thank you for response. Are you able to use the pathology report to retrieve the measurements since provider didn't supply in documentation?
 
I believe you could as a last resort, but lesions shrink in the formalin when sent to the lab. Worst case you may have one that goes from more than 3 cm to less than, but at least you will have a dimension.

Ideally, size of lipoma should be documented at time of removal.

With this many, however, you'll have to submit with notes anyways.
 
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