cyst excision vs 27047

SallieF

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Surgeon wants to bill 27047 for an inflammed cyst excision. I have been told so many different ways to code these I am now at a loss :confused:. I was hoping for some real coders input after you read his op note:
PROCEDURE: excision 2cm subcutaneous cyst with layered closure, left groin.
PREOPERATIVE DIAGNOSIS: recurrent infection w/subq cyst left groin.
POSTOPERATIVE DIAGNOSIS: recurrent infection w/subq cyst left groin, path pending.
INDICATIONS: pt is 47yo male who earlier this month had an obvious infected cyst left groin & had responded to conserviative therapy now presenting for excision.
PROCEDURE: IV sedation, left groin clipped/prepped/draped normal sterile fashion.
Elliptical incision 8X3cm oriented slightly obliquely in the left groin was made over the inflammatory mass, which was excised sharply and compltely with cautery aall the way down to the superficial fascia. The wound was then closed in layers with 3-0 and 4-0 Vicryl followed by Benzoin, Steri Strips, gauze and Tegaderm. Patient sent home today.
PATHOLOGY: Skin with ruptured, inflammed epidermal inclusion cyst.
Thanks to all who reply
 

SallieF

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i am so glad some one else agrees with me. i have been discussing this with the revenue manager and surgeon and both are telling me to bill the soft tissue tumor codes.
any other coders have input?
 

Lujanwj

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Agree.

Pathology says everything you need to know -inflammed epidermal inclusion cyst which means it's integumentary. For more supporting evidence see Excision - Begin Lesion guidelines as it states "Cystic lesions".
 
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