Lipoma HELP!

Lisa Bledsoe

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:confused: We have a patient who has had multiple lipoma's excised. On one day, he had 26 lipomas excised from his back and hips. The doctor is coding 27047 for the first, then 27047 -59 on multiple separate line items. Same patient, different date - 27323 and 27323 -59 again multiple line items (from the anterior thigh). IS THIS RIGHT? It doesn't seem right to me... incidentally none of the lipomas went to pathology and 27323 specifically states biopsy. Should we be coding from the 11400-11406 section? Thanks for the help!
 

amitjoshi4

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Lipoma

Hello,

We need to know first the extent of lipoma. Is it deep or superficial.

Secondly whether each lipoma was excised through Separate incision.

21930-Excision, tumor, soft tissue of back or flank : this is to be used for back lipoma. If there are multiple lipomas and each one with separate incision then go with 21930 and subsequent lipomas with 59 modifier. 214.1 for subq and 214.8 for other.

27047/27048 is correct for hips.

If thighs are involved then 27327/27328 is the correct choice with 59 modifier if all are being excised with separate incision.

Biopsy Codes cannot be used here.

Thank You
 
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Lisa Bledsoe

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Amit - thank you for your response. In reference to the fact that 27323 states "biopsy" and the lipomas were not sent to pathology...would this still be the correct code?
Lisa
 

amitjoshi4

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Lipoma

Lisa- Your question itself states the answer.If no specimen was sent to path hence no Biopsy was obtained.Go with the excision codes and not the Biospsy ones.

Remember always the golden rule:

Excisional Biopsy is always Excision

Thank You
 
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