Mons pubis abscess

Lisa Bledsoe

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The patient had 3 abscesses I&D'd - one large on the mons pubis, one small on the labia majora and one small on the lower abdomen. Would you code 56405 for the mons pubis and 10061-59 for the other two?
 

amolson1325

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Hey Lisa,

I would code them all from the integumentary system. Codes 56405-59899 deal with the vulva, perineum and interoitus, vagina, cervix, uterus, oviducts, and ovaries. The Mons pubis and libia majora are not considered in the perineum, so I say you could use 10061 for all three.

Hope this helps and correct me if I'm wrong but that's what I see. :)
 

dmaec

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no, I wouldn't code the 56405 for the mons pubis...I'd be using the abdomen code for that area as well. Mons pubis is basically - 'on top' ...the fatty tissue above the pubic bone - (normally covered by hair once puberty hits)

{that's my opinion on the posted matter}

yup...I agree with Angie :)
 
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Lisa Bledsoe

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HI girls! :) This is the definition of 56405 from EncoderPro CPT lay descriptions:

"The vulva includes the labia majora, labia minora, mons pubis, bulb of the vestibule, vestibule of the vagina, greater and lesser vestibular glands, and vaginal orifice. The perineum is the area between the vulva and the anus. The physician makes an incision into the abscess at its softest point and drains the purulent contents. The cavity of the abscess is flushed and often packed with medicated gauze to facilitate drainage."

Based on this definition of the code, would you still only code integ?

Lisa;)
 

amolson1325

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Hi Lisa,

You are absolutely right! I was looking at a picture (lovely) and placing each area not paying attention that the vulva includes all that. I was more focused on the perineum which all your areas are out of. So....I guess you could use that 56405 for the mons pubis and libia and use the integ. for the abdomen. Great call!
 

dmaec

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hmm..well, though in the CDR it does state that, I don't see how the mons pubis can be included in the vulva area.... that being said, I probably still wouldn't use that code for the mons - however, THAT being said, it wouldn't be wrong to use it according to the CDR description.

I'm not being much help am I ;)
 

amolson1325

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Donna I'm with you....I didn't think it would be in the vulva either. But, in the anatomy book is says exactly what Lisa said! So I guess we all learned something new today! :D
 

Lisa Bledsoe

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Ok - so I went to my Taber's...this edition includes an illustration. Based on this information and the CDR, looks like I really have 2 I&D's of the vulva (mons pubis and labia majora0 and one integ of the lower abdomen... Which leads me to wonder if I can code 56405, 56405-59, 10061-59...???

(Taber's states "that portion of the female external genitalia lying posterior to the mons vernis, consisting of the labia majora, labia minora, clitoris, vestibule of the vagina, vaginal opening, Bartholin's glands.")

I appreciate your help ladies!!
 

amolson1325

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Hey Lisa,

I was trying to find confirmation that you could code them separately like you did and I can't find anywhere that it says you can't. I found if there were lesions in the same area you only code once but nothing about abscess. I would think you could because it doesn't say anything about single or multiple abscess, not even in the integ. section.

At this point you may know the answer already!
 

Lisa Bledsoe

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Angie - I can't find anything that says I can't code the scenario... I just want to be sure, because she originally coded (get this) 26990...and we will be looking at sending some money back to the insurance along with a corrected claim for the correct charges. I don't want it to be more of a mess than it already is! :eek:

And it's wonderful that we all learned something today!:rolleyes:
 
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That's how I'd code it ...

Ok - so I went to my Taber's...this edition includes an illustration. Based on this information and the CDR, looks like I really have 2 I&D's of the vulva (mons pubis and labia majora0 and one integ of the lower abdomen... Which leads me to wonder if I can code 56405, 56405-59, 10061-59...???

(Taber's states "that portion of the female external genitalia lying posterior to the mons vernis, consisting of the labia majora, labia minora, clitoris, vestibule of the vagina, vaginal opening, Bartholin's glands.")

I appreciate your help ladies!!

Lisa,
That's how I'd code it ... including the -59 modifier on the 2d and 3d procedures.
F Tessa Bartels, CPC, CPC-E/M
 
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