excision chronic sinus tract abdomen

deborahcook4040

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The coding for this seems to be all over the place, so I'm throwing it out to the hive mind for some advice. Pt has a post surgical chronic draining sinus of the abdomen. MD opened the sinus, excised the entire sinus tract (approximately 2 inches deep) and a prolene suture he found at the bottom (just above, but not extending into the fascia). Further debridement of the scar tissue and chronically inflamed tissue was done as well. multiple layer closure was performed.

The CPT index under Sinus > Excision directs me to look at Excision > Cyst/Sinus. There is no Cyst/Sinus indented under Excision, so I presume I am meant to use Cyst. I suppose a sinus does meet the technical definition of a cyst: "a thin-walled, hollow organ or cavity containing a liquid secretion". I would therefore code this as excision of a cyst, abdomen, CPT 22902 (since my MD did not record the width of the excision).

What are your thoughts?
 
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