Question Hidradenitis Suppurativa Excision-Inframammary

danetta04

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I have an encounter where the the provider performed an excision for Hidradenitis Suppurativa of the inframammary fold w/intermediate repair. Should this be coded with CPT 11450- Excision of skin and subcutaneous tissue for hidradenitis, axillary? I'm questioning this because of the location and these sets of codes do not specify this location.
 

sinman0531

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The axillary is generally considered to be the armpit area ("under the shoulder joint" is how its worded) whereas inframammary is directly under the breast tissue where the breast meets with the chest. Was it truly an inframammary excision, or was it on the *side* of the breast? If it was truly inframammary, then that would just be a benign excision with intermediate repair, 2 separate codes. If it was more on the side of the breast, then you would be correct.
 

vernal2

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The axillary is generally considered to be the armpit area ("under the shoulder joint" is how its worded) whereas inframammary is directly under the breast tissue where the breast meets with the chest. Was it truly an inframammary excision, or was it on the *side* of the breast? If it was truly inframammary, then that would just be a benign excision with intermediate repair, 2 separate codes. If it was more on the side of the breast, then you would be correct.
If the hidradenitis was I&D first and then excised, can you bill both?
 

sinman0531

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On that subject, can you bill a I&D and excision of the same hidradenitis in the axillary? She I&D it first then decided to excise it. HELP!
If the incision was actually made, then yes technically you can bill for both...however, if records are requested, one would be denied or recouped....based on NCCI edits, the I&D would be paid and the excision would be recouped (which I think is weird since it is the more involved procedure).
 
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