I think you could use the 57135 - Excision of vaginal cyst or tumor with a modifier 22 for the additional work assuming that an extra 20 minutes is 25-50% more time than the procedure would normally take you to complete. I would suggest 623.7 - polyp of vagina and 623.4 - old laceration of vagina as the diagnosis codes based on your post.
Ruth Perkins, CPC, COBGC
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