Wiki Excision of Sebaceous Cyst-not sent to pathology

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Excision of Sebaceous Cyst Not Sent to Pathology

For excision of the entire cyst, sac, and all contents (in other words, the surgeon doesn’t simply drain the contents), look first to the excision of benign lesion codes 11400-11446 (specifically 11420-11426 for the neck), depending on the size. For deeper excision, such as removal of tissue below the subcutaneous level, see 21555 Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; less than 3 cm or 21552 Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; 3 cm or greater. If documentation does not indicate the depth from which the cyst was removed, query the physician.

cmac

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Does anyone know the CPT for an excision of a sebaceuos cyst not sent to pathology? Would it still be the excision of benign lesion codes based on the size? He made an incision and cut the cyst out of the patient's neck.
Any suggestions?
thanks
 

noell426

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Exc of a sebaceous cyst

I agree that the correct CPT would be either 10060 or 10061. However, be careful with diagnosing. According to Medicare, 706.2 is not a payable diagnosis for I&D. Medicare states that "the medical necessity diagnosis code must represent an abcess, not the underlying condition causing the abscess." The supported ICD-9's are as follows: 528.5, 607.2, 680.0-680.9,681.10-681.11, 682.0-682.9, 705.83, and 3611.0.
 

smwermter

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If he excised the entire cyst, sac and all contents (not just drained the contents) then i would use the excision of benign lesion codes 11400-11446 depending on the size. :)
 

mbort

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I would pay very close attention to the depth of the incision. If he took this below the subcutaneous tissue, then you are looking at 21555 and not the benign lesion code series from the integ section.
 

smwermter

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17000 is destruction of "premalignant" lesion...not a sebaceous cyst. I would use the excision range of codes...depending on the depth as mbort pointed out. :)



17000-17003 (17000, 17003)

The physician destroys or excises premalignant lesions using a laser, electrosurgery, cryosurgery, chemical treatment, or surgical curettement. Local anesthesia is included. Report 17000 when one lesion is destroyed and 17003 when two to 14 lesions are destroyed.
 

magnolia1

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mbort is correct.

If your documentation does not indicate the depth from which the cyst was removed, you need to query the physician. (Though more than likely, in this case you're code range will be 11420--11426)

In the absence of a Path report, you would be okay with 706.2 if the physician stated that was what was removed.

Karen Maloney, CPC
Data Quality Specialist
 
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