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Wiki cyst/lipoma excision

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stogsmom3

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New Palestine, IN
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There has been a debate. The providers don't always document the size of incision made to remove a sebaceous cyst or Lipomas. Do we code the size off the size of cyst/lipoma documented. Or should the size be based off the size of incision that is made. All I really find is how to code lesions with incision and margins. But, I've always thought these are different.

Sebaceous cyst 3X2X1 cm or 2 cm incision
 
I have run into the same area of concern. If a lipoma or cyst is documented with a pre-op size of 3.5cm and a 5mm punch tool is used to make the incision and push the cyst or lipoma through, do we code based on the pre-op size documented or the 5mm punch tool used? And is this an I&D or an excision?
 
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