Lipoma Coding

[Hopp]

Hey Just wondering if someone would be able to help with
coding the following: Exc. 2 cm mass of the chest -doc.says layered closure Pathology:Lipoma

Thinking it would be 11402 and 12031 is this right? Thanks for your help
Deb Hopp,CPC

[Luckydog595]

Yes, this is correct. Denise

[Hopp]

Thank you Denise for your help - Deb,CPC

[Jarts]

What about 21555? In my coding companion it lists lipoma as an acceptable dx and it has a higher RVU than the other two codes above combined.

It does have a 90 day global versus 10 days for the integumentary codes, though.

I was encouraged to use the "tumor" removal codes for lipomas (fatty tumors) in an old General Surgery Coding Alert. They indicated, since lipomas are usually found in the subcutaneous tissue, not the skin, the musculoskeletal section of the CPT book is the place to look.

Anyone else have thoughts on which is the more correct code to use?

[mjewett]

Lesion removal codes 11400-11446 are for excision of lesions through the dermis only. Lipomas are located in the subcutaneous tissue, so they should be coded from the Musculoskeletal section. I agree with (Jarts) code 21555 is appropriate.

Melissa-CPC

[fcallahan]

I need help coding Lipomas.
Where can I find documentation explaining the difference between the 114 procedure codes and the 2XX(Muscle) codes.

I remember some time ago that Coding Edge had an article about Coding for Lipomas, but don't remember what month.

Thanks for all your help, Freda

[Jamie Dezenzo]

Just an example and hope it helps and agree w/ Jarts


Although musculoskeletal codes offer increased pay for more complicated, deeper excisions, some exceptions may apply, says Lisa Center, CPC, physician billing certified professional coder with Mt. Carmel Regional Medical Center in Pittsburg, KS.

Example: A patient presents to your practice with a 2-cm lipoma on his forehead that appears to lie under the frontalis muscle.

Take note: If your physician performs a lipoma excision in the flank, you should report 21930 (Excision, tumor, soft tissue of back or flank) because lipomas typically develop in the subcutaneous tissue beneath the skin. Code 21930 will pay you about $420.

This general principle does not apply to lipomas on the face or forehead, however, because in such instances the skin is so close to the bone, Center says.

For the instance above, the only facial musculo-skeletal excision code, other than those involving bone, is 21015 (Radical resection of tumor [e.g., malignant neoplasm], soft tissue of face or scalp). But because the physician did not perform a radical resection, you should not report 21015.

So, you should bill 11442 (Excision, other benign lesion, face ...; excised diameter 1.1 to 2.0 cm) for the lipoma excision on the patient’s forehead, which will pay you $170. Although the payment amount is undeniably less, all experts agree that you should only report the code that best describes what your physician documents

[fcallahan]

Thank you, Freda

[Chronicles Billing]

Thank you, Freda

Don't forget to consider the closure. was it simple or complex depending on the documentation?

[lovetocode]

Would you agree now that we could charge codes 21011-21014 for lipoma of the face?