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Help please! 25112 vs 25076

  1. #1
    Question Help please! 25112 vs 25076
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    Can 25112 be coded since this was not a "ganglion"? I feel like I am over thinking this! Dr. also wants this billed with a -22 modifier for the extra work but couldn't 11042 be billed for the scar debridement? I would appreciate any insight! Thanks.

    Post Op Diagnosis: Recurrent left dorsal wrist mass. Path report says Benign adipose tissue.

    Procedure: Revision removal ulnar wrist mass which appeared to be a calcified cyst or a ganglion cyst. Description: A portion of her prior incision was used. More extensive than usual dissection was needed because of the ample amount of scar tissue she had and care was taken not to involve any of the digital, radial, dorsal radial nerve branches, therefore extra time was spent and extra effort was needed, more so than the usual for a ganglion cyst excision in order to dissect out the anatomy and identify the anatomy because her prior procedures which had left scar. Once the cyst was identified it was sharply excised and sent off the field and then it was rongeured down to the wrist capsule in order to prevent recurrence.

  2. Default
    Benign adipose tissue is essentially a lipoma, so you may want to look at 25110. The approach and prior scar resection would be the 22 modifier so I wouldn't use the 11042.
    I always catch myself overthinking, espcially the simple procedures!
    Bruce Crandall, CPC
    North Carolina Specialty Hospital
    Durham, NC

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