Excision of pilonidal cyst with rhomboid flap

[R1CPC]

Hi there if anyone can please tell me if we can bill an excision of pilonidal cyst 11772 and a rhomboid flap 14000? Please explain when we can bill or why we would not?

 

[syllingk]

if they did a flap advancement then you would not bill the cyst excision as it would be included in the repair.

 

[R1CPC]

thanks for your reply but I'm wondering how you came up with this answer? if you check the codes against CCI they are not bundled. I understand the cpt guidelines state not to separately report excision of a benign or malignant lesion however the codes are listed as 11600-11646 or 11400-11446, CPT 11772 is not listed as one of the codes.

 

[syllingk]

if you go to the flap advancement code it says not to code the lesion removal, only the advancement.

 

[CodingKing]

Pilonidal Cyst doesn't fall under lesion under CPT. It has its own set of codes.

The same section about Excision being included specifically mention the lesion codes

Codes 14000-14302 are used for excision (including lesion) and/or repair by adjacent tissue transfer or rearrangement (eg, Z-plasty, W-plasty, V-Y plasty, rotation flap, random island flap, advancement flap)................
........
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The excision of a benign lesion (11400-11446) or a malignant lesion (11600-11646) is not separately reportable with codes 14000-14302.

Same wording is the the NCCI Manual.

 

[R1CPC]

Hi Coding King to clarify your post are you saying 11772 and 14000 can be reported separately?

 

[R1CPC]

Hello can someone please confirm.