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mass excisions

Brendal

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When coding excision of epidermal inclusion cyst you need to know how deep the doctor went. If it is just the dermis then it is integumentary. Musculoskeletal excisions are below the skin in the subcutaneous tissue but above the deep fascia. Also, if the path report says epidermal inclusion cyst then you must code it that way.
 

nsteinhauser

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Here's the cpt assistant paragraph from January 2011... hope this helps answer your question.

Surgery: Integumentary System

Question:The patient has a large 4-cm sebaceous cyst in the middle of the back. The incision was made right over the cyst, cutting through skin and subcutaneous tissue. Should this be reported from the Integumentary or Musculoskeletal system codes?

Answer:The appropriate code for this procedure (excision of benign lesion codes 11400-11406 of the Integumentary subsection) would be based on the size of the excised diameter. These tumors originate from the dermis or adnexal structures and are not considered soft tissue tumors, even though they may protrude into subcutaneous tissue
 
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