integumentary vs musculoskeletal?

BFAITHFUL

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Not sure which CPT code to use for the following integumentary vs musculoskeletal?



A time out was performed prior to incision. Once consent was obtained, the patient was taken to the operating room and placed supine. Once anesthesia was provided, the abdomen was prepped and draped in the standard surgical fashion. After sedation was applied by the anesthesiologist, I used 20 mL of local to give local infiltrated block circumferentially around the lesion. I then used a 15 blade scalpel creating an elliptical incision around this obtaining approximately 8 to 9 mm margins on each side. This was carried down with Bovie electrocautery to the anterior abdominal wall fascia. After we excised, it was sent off as permanent section.


I did demarcate the medial aspect with a long silk, the lateral wall with a short silk and the superior aspect of the lesion with a long Prolene and it was then sent off as permanent. I then dried the area. Hemostasis appeared controlled without any further maneuvers. I then used 2 0 Vicryl and SH to approximate the subcutaneous tissues. I then gave another 10 mL of local. I then dried the area. I used 4 0 Monocryl to approximate the skin. The incision was cleansed and dried and Dermabond applied over this.
 

btadlock1

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Not sure which CPT code to use for the following integumentary vs musculoskeletal?



A time out was performed prior to incision. Once consent was obtained, the patient was taken to the operating room and placed supine. Once anesthesia was provided, the abdomen was prepped and draped in the standard surgical fashion. After sedation was applied by the anesthesiologist, I used 20 mL of local to give local infiltrated block circumferentially around the lesion. I then used a 15 blade scalpel creating an elliptical incision around this obtaining approximately 8 to 9 mm margins on each side. This was carried down with Bovie electrocautery to the anterior abdominal wall fascia. After we excised, it was sent off as permanent section.


I did demarcate the medial aspect with a long silk, the lateral wall with a short silk and the superior aspect of the lesion with a long Prolene and it was then sent off as permanent. I then dried the area. Hemostasis appeared controlled without any further maneuvers. I then used 2 0 Vicryl and SH to approximate the subcutaneous tissues. I then gave another 10 mL of local. I then dried the area. I used 4 0 Monocryl to approximate the skin. The incision was cleansed and dried and Dermabond applied over this.
Integumentary - no muscular involvement, but it did go all the way through the subcutaneous layer. Choose the code based on malignant or benign, the total excised diameter (including margins). Report an intermediate repair separately, for the layered closure. ;)
 
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