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Perianal lesion removal code

  1. #1
    Location
    Watertown New York
    Posts
    16
    Question Perianal lesion removal code
    Medical Coding Books
    A patient had an excision of a malignant lesion of the perianal area. Our coding team has a disagreement on which code to use. One coder suggested 11623 and the other would like to use an unlisted code such as 46999. Is a perianal area considered part of "genitalia"?

  2. #2
    Default
    Per concept, I would agree with 11623 with repair, but depending on extent of resection and repair, if no codes describes in the digestive system section, then an unlisted code would do.

  3. #3
    Location
    Watertown New York
    Posts
    16
    Question
    Thanks, I guess the real info that I need is more anatomical, is the perianal region considered part of the genitalia?

  4. #4
    Default
    Yes it is, and whats funny is that I am working on the same case right now.

    radical resection 5 cm mass right perianal space juxtaposed to the external sphincters.

    I will be using 46999 with fee of $1585 mocking fee for 45171 because of extent of removal, and this was a recurrent melanoma

  5. #5
    Location
    Milwaukee WI
    Posts
    4,466
    Default 46922
    Did you consider CPT 46922 ... surgical excision of anal lesions

    F Tessa Bartels, CPC, CEMC

  6. #6
    Default
    Quote Originally Posted by FTessaBartels View Post
    Did you consider CPT 46922 ... surgical excision of anal lesions

    F Tessa Bartels, CPC, CEMC

    For my cases, they were more extensive then what the code describes, considering the fee as well...But 46922 is a good code too!

  7. Smile
    46922 is "destruction". This would not be correct in this case.
    You should definitely use the 11400-11440 codes.

  8. #8
    Location
    Milwaukee WI
    Posts
    4,466
    Default 46922
    Quote Originally Posted by kristi.ford@dayton.miamijacobs.edu View Post
    46922 is "destruction". This would not be correct in this case.
    You should definitely use the 11400-11440 codes.
    Please read the code description AFTER the semi-colon
    46922 - Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision

    This code is definitely for excision of such lesions.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  9. Default
    Perianal, to me, suggests that the lesion is not on the anus so 46*** series would not be appropriate. If the lesion is integumentary, look at 11623 plus inter/complex closure. If soft tissue use 27059. If the anus is involved theses codes will not work and the other suggestions are more appropriate. Just be sure the of the anus' involvement in the procedure.

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