Wiki excision of vulva tissue

[Korbc]

hey guys
just curious if doctor is removing some tissue around the vaginal orifice and perineum. could you use 56620 or would part of the labia minora or majora have to be excised for you to be able to use that code....

For excision of some external vaginal tissue or I guess specially vulva tissue....
At what point would you need to use say a 11620-11626 (excision of malignant lesion i.e. genitalia) vs the 56620 for "removal of part or all of the vulva to treat premalignant or malignant lesions" per verbiage of optum coding companion

This is just a hypothetical that i came across coding for something else, so there's no op note or anything like that to give

Thanks!

 

[csperoni]

As a hypothetical, it's hard to give definitive answers, and you seem to be asking 2 questions.
1) Depending on what type of tissue the physician calls it and the description of what was performed, that would determine whether I am coding something like a partial vulvectomy vs excision of a lesion vs perineorrhaphy.

2) You seem to be asking at what point does removal of a malignant vulvar lesion become a vulvectomy. If you have access to the ob/gyn coding alerts: https://www.aapc.com/codes/coding-n...u-be-the-coder-wide-excision-of-vulva-article is a good reference. It depends on the depth/size/complexity. Basic idea - WLE of lesion and subq tissue for malignant or pre-malignant lesions would be coded as vulvectomy. Excising a defined lesion for benign conditions would be 11420-11426. I would only use 1162___ if it was shallow or one defined malignant lesion, not a deep, wide local excision or multiple lesions.

 

[Korbc]

As a hypothetical, it's hard to give definitive answers, and you seem to be asking 2 questions.
1) Depending on what type of tissue the physician calls it and the description of what was performed, that would determine whether I am coding something like a partial vulvectomy vs excision of a lesion vs perineorrhaphy.

2) You seem to be asking at what point does removal of a malignant vulvar lesion become a vulvectomy. If you have access to the ob/gyn coding alerts: https://www.aapc.com/codes/coding-n...u-be-the-coder-wide-excision-of-vulva-article is a good reference. It depends on the depth/size/complexity. Basic idea - WLE of lesion and subq tissue for malignant or pre-malignant lesions would be coded as vulvectomy. Excising a defined lesion for benign conditions would be 11420-11426. I would only use 1162___ if it was shallow or one defined malignant lesion, not a deep, wide local excision or multiple lesions.

thanks so much!