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lipoma excision cpt code

  1. #1
    Default lipoma excision cpt code
    Medical Coding Books
    I'm struggling if I should code the lipoma excision from forearm from the intugumenary section or muscle skelatal section.

    patient had two lipomas excised from the forearm, one 4cm one 1.4 cm in size.

    I don't know if I code:
    12032 - repair
    11404-59 - excision
    11402- 59 - excision

    OR

    25071 -59(excision tumor 3cm or greater, subcutaneous)
    25075 -59 (excision tumor 3cm or less, subcutaneous)

    Help appreciated

    I also find it strange that the excision of the smaller tumor (25075) gets paid more than the excision of a larger tumor (25071), I checked this through aetna's patient cost estimator and cms fee schedule look up and they both turn up that the smaller excision gets paid more than the larger one, very weird.
    Last edited by JesseL; 07-25-2014 at 01:23 PM.

  2. #2
    Default ama 2014 CPT
    I also noticed that the AMA 2014 CPT books seems to have the size description backwards.

    25071 should be less than 3cm but the book has it as greater than 3cm..

    and 25075 should be greater than 3cm not less.. anyone else seeing this in there cpt books?

  3. #3
    Default
    Also, watch your LCD's too. Our MAC Novitas does not list 214.1 icd9 as allowed for 114xx codes.

  4. #4
    Default
    The codes are out of sequence. Many of them the soft tissue excision codes are. Aetna may have the contract info loaded incorrectly or based on the CPT as if they were in sequence.

  5. #5
    Default
    lipoma is tumor of fat........in M/S section

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