Wiki exc of lipoma vs. cyst

[jwiles66]

I'm hoping someone can clarify this for us. When coding for an excision of a sebaceous cyst do you use the exc of benign lesions codes? and for exc of a lipoma do you use the exc of soft tissue mass codes under the muskulosketal system? Our office seems to have some confusion with this.

 

[jdibble]

I'm hoping someone can clarify this for us. When coding for an excision of a sebaceous cyst do you use the exc of benign lesions codes? and for exc of a lipoma do you use the exc of soft tissue mass codes under the muskulosketal system? Our office seems to have some confusion with this.

Hi Meghan,

This was always a confusion for my surgeons! Through research I found descriptions of the differences in order to help them choose the correct codes.

If the lesion begins at the skin and goes into the subcutaneous tissue, then you would use the benign (or malignant) skin lesion codes. Sebaceous cysts would fall into this category. If the surgeon has to cut into the skin to locate a lesion below the skin, in the subcu, fascia etc., as in lipomas, then you would use the muskuloskeletal codes. Of course the documentation must also support these procedures. If the doctor does not document the depth (as well as the size of the lesion) - that he went down into the subcu or fascia, then you can't use the musculo-skeletal codes.

Hope this helps!