10-12-2017, 07:22 AM | Community Wiki

Results 1 to 1 of 1

Coding muscle biopsy 20200 vs 27324

  1. #1
    Default Coding muscle biopsy 20200 vs 27324
    Medical Coding Books
    I code for ASC/outpatient and I have a surgeon who has been advocating for 27324 over 20200 for muscle Bx cases. I have two brief notes to share as examples.

    Is there any one who can explain which code is correct and why in these cases?

    27324 - Biopsy, soft tissue of thigh or knee area; deep (subfascial or intramuscular)
    20200 - Biopsy, muscle; superficial

    Case 1 :

    PREOPERATIVE DIAGNOSIS: Myopathy.
    POSTOPERATIVE DIAGNOSIS: Myopathy
    PROCEDURE: Underwent right quadriceps muscle biopsy.
    COMPLICATIONS: None.
    SPECIMENS: Sent to pathology.
    ANESTHESIA: MAC anesthesia and local anesthetic.

    HISTORY OF PRESENT ILLNESS:The patient was referred to our Neurosurgery Department for muscle biopsy... consent in my presence.

    PROCEDURE IN DETAIL: The patient was brought to the operating room on April 18, 2017... the right thigh was prepped and draped using chlorhexidine prep.

    A 2-inch incision was made over the right vastus lateralis muscle and following local anesthet ic infiltration, a #15 blade was used to make an incision following adequate anesthetic. Incision was then brought down to the fascia and self-retaining retractor was brought in the field. The fascia was identified and cut The fascia! Following adequate hemostasis and copious irrigation, the fascia was closed with inverted interrupted Vicryl suture and
    inverted interrupted Vicryl suture in the deep dermal layer, and subcuticular Monocryl for skin...

    Final Pathologic Diagnosis:
    1. Skeletal muscle, right quadriceps, biopsy - Mild myopathic changes

    Case 2 :

    PROCEDURE PERFORMED Left vastus lateralis muscle biopsy
    PREOPERATIVE DIAGNOSIS Muscle problems with history of rhabdomyolysis .
    POSTOPERATIVE DIAGNOSIS Muscle problems with history of rhabdomyolysis .
    ANESTHESIA: 1% lidocaine buffered with bicarbonate and IV sedation .

    INDICATIONS: The patient is an 18-year-old male with a history of exercise-induced rhab domyolysis. An extensive workup was carried out. Muscle biopsy was requested in order to assist in the diagnosis...

    FINDINGS: At the lime of surgery, the muscle was somewhat pale in appearance The muscle was otherwise grossly normal.

    DESCRIPTION OF PROCEDURE: The patient was taken to the operating room , and the left lateral thigh region was shaved, prepped and draped in a sterile fashion . 1% lidocaine buffered with bicarbonate was used to anesthetize the skin and subcutaneous tissues . A 2-inch incision was then made sharply through the skin, down to the deep fascial layer. Points of bleeding in the subcutaneous tissues were cauter ized with bipolar cautery . A self-retaining retractor was then placed . At this point, the deep fascia was incise d. Samples of muscle were then obtained and sent for pathological evaluation. At this point, hemostasis was assured and the wound was irrigated . The wound was then closed with Vicryl sutures in the fascial and subcutaneous layers A running Monocryl suture was used to reapproximate the skin edges Steri-Strip tapes were placed across the incision and a sterile dressing was applied...

    Final Pathologic Diagnosis:
    1. Skeletal muscle, left quadriceps, biopsy - Mild myopathic changes

Similar Threads

  1. Muscle Biopsy Deep
    By mjsjeep in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 04-08-2014, 10:16 AM
  2. muscle biopsy
    By mlangford in forum Orthopaedics
    Replies: 0
    Last Post: 01-07-2013, 02:49 PM
  3. 20205 vs 27324
    By Lashel in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 05-18-2012, 09:46 AM
  4. Pectoralis muscle biopsy
    By prabha in forum Interventional Radiology
    Replies: 2
    Last Post: 07-29-2009, 10:51 PM
  5. I&D deep hematoma vs. muscle biopsy
    By Leanne in forum General Surgery
    Replies: 0
    Last Post: 07-15-2009, 10:04 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.