Frozen section diagnosis


Paducah, KY
Best answers
Please I desperately need help! I just started coding ENT - my background is general/vascular surgery. So I have TONS of general questions, which I'll get to later, but I have a very thorny issue right now.
The ENT doc took a pt. to surgery for biopsy of a deep neck node biopsy. This node was removed and sent for frozen section, and came back as metastatic squamous cell. BASED ON THAT DIAGNOSIS: he proceeded to do a diagnostic direct larygoscopy, tonsillectomy, nasolaryngoscopy and biopsy of the tongue base x2.
Permanent pathology came back as benign branchial cleft cyst with necrosis of the epithelial lining, microscopic focus of residual benign squamous epithelial lining of the branchial cleft cyst with no morphologic evidence to support a malignant diagnosis.
How do I code this??? The tonsils, tongue biopsies, etc, are perfectly normal. There is no diagnosis for any of this after the lymph node.
I appreciate your help!
And I also would appreciate any input on learning ENT coding - my problem right now - as stupid as it may sound, is wax removal in the office by the physician.

Thanks again !