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38525 or 19120

  1. #1
    Default 38525 or 19120
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    Patient had an excision and biopsy of rt axillary mass
    this is a patient with a mass in rt axilla consistent with a lipoma for axillary breast tissue consented for biopsy.
    Procedure - the rt axilla was prepped and draped in a sterile fashion. A linear incision was made directly over the mass. Electrocautery was used to dissect through the subcutaneous tissue down to the mass. Flaps were created towards the arm and towards the chest. Dissection was then carried down to into the lymph node bearing tissue of the axilla to competly excise the mass. . It apperared consistent with a lipoma. Some of the overlying skin was also excised.. The wound was irrigated with normal saline. now Thw subcutaneous tissue was closed with interrupted 3-0 vicryl suture.

    path report came back as 610.1 -benign fatty tissue
    now it seems to USE 38525 -LYMPH NODE BUT SOMEONE told me to use 19120 ? what do you think ?

  2. #2
    just a note -

    I dont think I can code a lymph node, because no lymph node was excised , but is therere a code for axillary mass -maybe 1140x series if not the only code I see would be a breast mass ?, any other ideas please post them -thanks
    Last edited by codedog; 06-21-2010 at 12:36 PM.

  3. #3
    Kansas City, MO
    Im confused. You said dx came back as 610.1 "benign fatty tissue" but description for that code is "diffuse cystic mastopathy" or cystic breast tissue/disease. So I am not real clear on what your dx is.

    I say no to the are right...not a lymph node.

    If it was an axillary mass/lipoma, consider the 21552-21555 section???

    If it was a breast issue (cystic) I would look at 19101 or 19120.

    If it was just a lump of fatty tissue that 'felt like a lump" then I might consider the skin excision codes with an intermediate repair ( I think you had layered closure?) But...these are SKIN LESION codes. I personally think these are way overused for subcutaneous masses.

    Remember a "tumor" is any sort of abnormal growth, even if ultimately benign, so don't let that word throw you off.

    Just thowing out my two cents. Could be worth every penny
    Linda Vargas, CPC, CPCO, CPMA, CPC-I, CEMC,CCC
    PMCC Licensed Instructor
    Kansas City, MO Chapter
    President, 2018
    Vice President, 2017
    Member Development Officer 2016
    Harrisonville, MO Chapter President - 2013
    ICD-10 Education Coordinator- 2012
    Chapter President - 2011
    President Elect - 2010

  4. #4
    oh , pathlogist stated in path report that no lymph nodes are identified and that a few of the breast ducts were mildy dilated and that it could suppose it could be a lipoma, but he was more in favor of simply a benign fatty axillary breast tissue- 610.1- -thats what was in path report -so it leans toward a breast excision code i think ?

  5. #5
    Someone else told me use cpt code 21555, I think its 19120 path report states its more benign fatty tissue, but I call the doc's office and his office does billing outsourcing and they used 11400 , Which I dont think that may not be it ? Confused on this one .

  6. #6
    doc office said they used 14000 because he did not state size in operative report, could this be right ?

  7. Default dx 610.01 denied for age
    Coventry of Ky denied for a 14 yr old patient saying due to age. The coding books do not give an age range but yet the insurance company is saying AMA says this code is for 15 and older. Now I'm not sure what code to use due to there is no age on any of the related codes. Any ideas?

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