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Wiki Umbilical exploration

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vkratzer

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We have a patient who is having recurrent episodes of purulent drainage from his umbilicus. He had a lap chole in 2006 but has only been symptomatic for the past several months. Surgeon is planning to do an umbilical exploration, debride any chronic infection, and look for retained foreign material. Not sure how to code this. Dependent on code, patient may require prior auth. Need an opinion for most appropriate CPT code (20102? 10061? 11005?). Thanks
 
Don't you just love pre-auths?

You might want to check with the surgeon to get a better feel for what s/he is anticipating ...

On the face of what you've given us, I'd rule out 20102.

So we're left with 10061 or 11005 ... it depends on how deep the surgeon will be going. With the limited info before us, I'd lean towards 10061.

But I'd print out the lay descriptions of these codes and talk to the surgeon to see which most closely fits what s/he is planning to do.

Just my opinion ...

F Tessa Bartels, CPC, CPC-E/m
 
Thank you for your advice. In the interim, I made a decision to choose 10061 and if the surgeon does something more extensive, I would notify the insurance company.
 
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