Results 1 to 7 of 7

Excision of lipomas 23071

  1. #1
    Red face Excision of lipomas 23071
    Medical Coding Books
    I have had an audit done on a operative report that says I should have coded 12032 for layer closure in addition to 23071. They agree with the 23071 and 214.1... I felt that the layer closure is included in the code for excison of tumor soft tissue less that 3 cm. Can anyone add to this to clear it up for me?
    thanks so much! p.s. would you have sequenced 11600 before 23071 just because the dx was 173.6?

  2. #2
    Location
    Athens, OH
    Posts
    27
    Default
    I also have trouble when coding for the lipoma excisions. My surgeon often does layered closures that we do not charge for due to the size of the lesion/lipoma he removed because I am in the same thinking as you.

    As far as the sequence of the codes, I would have billed the 23071 before the 11600 due to the higher charge.

  3. #3
    Location
    Coeur d'Alene
    Posts
    19
    Default
    Hi,

    We do these all the time. I have six surgeons and I do not charge for the closing. I figure it is in the excision. I have never been told differently. What kind of audit was it that told you you should?
    Becky

  4. Default
    The cpt guide line states that Excision- BenignLesions- Closure of defects created by incision/excision or trauma may require intermediate or complex closure.Repair by interm or complex must be reported separately
    It includes only nonlayered (SIMPLE) closure when performed.

  5. #5
    Default
    Are you including the 20000 series codes to that statement as well? thanks ...

  6. #6
    Location
    Dover Seacoast New Hampshire
    Posts
    1,970
    Default
    CPT 2010, in the green text under Musculoskeletal System Excision of subcutaneous soft-tissue tumors , it states "extensive undermining or other techniques to close a defect created by skin excision may require a complex repair which should be reported separately." (CPT Professional Edition, AMA, p.86). Code 12032 is an intermediate repair, not a complex repair. In this guidance, CPT is referring to adjacent tissue transfers such as Z-plasty, or complicated closures in the 131XX range. The excision codes in the integumentary system allow for additional code reporting for the intermediate closure, but you coded from the Musculoskeletal system, so that would not apply. I think your auditor may be incorrect, but it depends on what was truly documented.

    Any time we bring in an external auditor, we contract for the opportunity for our coders to participate in a 'rebuttal' session, to address coding recommendations made by the auditor that we deem incorrect. We also ask for regulatory guidance on any coding recommendation where the auditor suggests we made a coding error.

    Let us know how this turns out.
    Pam Brooks, MHA, COC, PCS, CPC, AAPC Fellow
    Coding Manager
    Wentworth-Douglass Hospital
    Dover, NH 03820

    If you can dream it, you can do it. Walt Disney

  7. #7
    Talking
    thanks for the great feedback all of you! I will let you know the outcome as I feel vindicated to some degree!

Similar Threads

  1. multiple lipomas
    By herrera4 in forum General Surgery
    Replies: 1
    Last Post: 12-09-2015, 12:02 PM
  2. Multiple Lipomas
    By MACACERES in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 10-21-2014, 12:15 PM
  3. multiple lipomas - medicare replacement
    By willette in forum Dermatology
    Replies: 0
    Last Post: 06-19-2012, 10:42 AM
  4. Multiple lipomas
    By trinalankford in forum General Surgery
    Replies: 5
    Last Post: 03-09-2012, 04:19 PM
  5. Lipomas
    By NESmith in forum Dermatology
    Replies: 1
    Last Post: 02-04-2010, 03:14 PM

Tags for this Thread

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.