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Cyst removal

  1. Default Cyst removal
    Medical Coding Books
    Hi everyone,

    I have a question, I have 2 providers that do cyst removals and both of them do it a different way, I'll explain...

    Provider one: Makes an incision across the top of the cyst, opens the pocket and scrapes out the cyst with scissors and snips it out and closes the wound with a repair. example: 1.0cm x 1.5cm no margins included so the selected code would be 11401 CPT of the arm. This doctor states that margins are never included to remove a cyst.

    Provider two: Cuts around the cyst, included margins, example: 1.0cm x 1.5cm with 0.5cm margins so the total removal would be 2.5cm post op. So the code selected would be 11403 CPT of the arm. This doctor has always done it this way...

    One gets a higher reimbursment than the other, who is right who is wrong? Or can they select the method of their choosing and continue to get payed based on their method of choice?



  2. #2
    Milwaukee WI
    Default Cyst vs Lesion
    I answered this question on the E/M forum.
    There is a difference between excision of a cyst and excision of a lesion.

    F Tessa Bartels, CPC, CEMC

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