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Wiki pre-auths for "masses'

R

rkindlund

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Bellingham, WA
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We are having a debate in our office about how to pick a code for pre-authorization in the case of "masses." Our general surgeons will see a patient and - prior to surgery - not know for sure whether the patient has a lipoma or sebaceous cyst, for example.

If it is sebaceous cyst we're looking at the 11400 codes (integumentary), but if it is a lipoma we will be doing a code from the musculoskeletal system.

I am inclined to always advise our authorization folks to pre-auth the higher/musculoskeletal code if the doctor is unsure what the "mass" is. Is this what others are doing?
 
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