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submental neck mass

  1. #1
    Location
    NEW ORLEANS
    Posts
    954
    Default submental neck mass
    Medical Coding Books
    Doc did an excisional biopsy of a submental neck mass. Pathlogy came back as a lymph node. I am looking at cpt code 38510 cervical node but his office says its cpt code 60280- excision of thyroglossal duct cyst or sinus-who is right , or are we both wrong


    op reads- a horiZontal incision was made and carried sdown through skin and subcutsaneous tissue. The platysmal muscle was identified and split. Subcutaneous fat was then entered and a node was encountered proximal to the mylohyoid musle. DFirect dissection was then carried outt in a circumferential fashion removing the node intact. The vascular pedicle was tied with a coated Vicryl suture. Asmaller node remained.It was bit larger than a centimeter. There was a small node next to it, which was also removed.
    Once this was accomplished, the area was copiously irrgated and reinspected. Several small bleeders were touched with cautery and procedure was terminated, Wounds were closedwith 5-0 Vicryl as well as chromic running and locking on the skin. Steri- Strips were alllied. -thanks

  2. #2
    Location
    Brownsville, Texas
    Posts
    13
    Default Neck mass
    Hello,

    I have used cpt code 21550 for our surgery center.

    Hope this helps you

  3. #3
    Location
    Philadelphia, PA
    Posts
    92
    Default Submental mass
    Hi Trent

    Going in for excision of neck mass down to muscle i would stick to 21556. He excised the node in full per the note. Did you have a path report before coding? if not, said I probably would stick to 21556 since he only mentioned 'a bit larger than 1 cm" and mentioned submental mass. Although, I must say this is where I get confused sometimes as to code a mass excision vs. lymphnode excision without the path.. 38510 would be applicable vs. the 60280.. imho
    Last edited by SS62; 10-22-2010 at 09:36 AM. Reason: clarification

  4. #4
    Location
    NEW ORLEANS
    Posts
    954
    Default
    thanks, 21556 i will do

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