mcollins130
New
The insurance company denied after pre-pay refer stating code is inaccurate.
Preoperative diagnosis: soft tissue NUB left upper arm
A 15-blade scalpel was used to make a vertical incision directly over the soft tissue mass. This was carried
down through the subcutaneous tissue using bipolar electrocautery. The mass was then grasped, elevated and carefully
excised from the surrounding tissues bipolar electrocautery. It did extend down to the level of the fascia. Specimen was
passed off the field. Wound was irrigated with saline and evacuated. Strict hemostasis was assured using bipolar
electrocautery. Skin edges were then approximated using interrupted sutures of 3-0 Vicryl. Skin was then closed using
sterile staples. Sterile dressings were applied.
The procedure was booked as a benign lipoma, but the path report came back as epidermal inclusion cyst. I certainly can understand why the reviewer thinks it should be 11406, but I don't want to assume they know best. It would be much easier to just send a corrected claim, but I want to make sure I understand.
Any feedback would be appreciated.
Preoperative diagnosis: soft tissue NUB left upper arm
A 15-blade scalpel was used to make a vertical incision directly over the soft tissue mass. This was carried
down through the subcutaneous tissue using bipolar electrocautery. The mass was then grasped, elevated and carefully
excised from the surrounding tissues bipolar electrocautery. It did extend down to the level of the fascia. Specimen was
passed off the field. Wound was irrigated with saline and evacuated. Strict hemostasis was assured using bipolar
electrocautery. Skin edges were then approximated using interrupted sutures of 3-0 Vicryl. Skin was then closed using
sterile staples. Sterile dressings were applied.
The procedure was booked as a benign lipoma, but the path report came back as epidermal inclusion cyst. I certainly can understand why the reviewer thinks it should be 11406, but I don't want to assume they know best. It would be much easier to just send a corrected claim, but I want to make sure I understand.
Any feedback would be appreciated.