Wiki Partial removal cyst wall, Recurrent Vulvar cyst

[JDuhaime]

Newer to OBGYN, looking for the appropriate code for the below. The provider would like to use unlisted 58999 compared to 56440 (Marsupialization of Bartholin's gland cyst). I am looking at maybe 114 section for excision or after everything I have researched points to 57135 Excision of vaginal cyst or tumor.

"Attention was directed to the cyst adjacent to the clitoris. The prior scar was observed just to the right of midline. A small opening was seen. I could palpation a 10x5mm cyst. The prior scar was opened including the cyst wall (about 5mm). The cyst wall was partially removed. Then the base of the cyst was sutured to the overlying epithelium in an interrupted fashion with about 6 sutures. Hemostasis was achieved with a small amount of bipolar. Hemostasis observed. This concluded the procedure."

I appreciate any guidance.

 

[Cmama12]

57135 is for a cyst or tumor in the vaginal wall. The lay description starts with the insertion of a speculum. In this case, the cyst is on the vulva. CPT directs us to 1142x or 1162x for excision of a local lesion. However, this part of the note base of the cyst was sutured to the overlying epithelium is similar to a marsupialization so I would lean towards the unlisted.