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Wiki painful lipomas Medicare

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Alice Marshall

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How would you code excision of multiple painful lipomas. Medicare says they are not covered however patient is experiencing pain to touch especially when lying down on back. I tried 11401 and 11402 214.1 v42.0 (also 782.0 and 586)
 
214.1 is the correct code if these are documented as lipomas, but if the excision is due to pain why not use a 338.19 first listed as long as the provider documents acute pain. Is the patient post kidney transplant? unless this is a complicating issue I would not add that code
 
I'd also consider using Musculoskeletal 21930 (depending on size) rather than a skin lesion. Lipomas are usually generated in the Subcu.
 
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