Results 1 to 4 of 4

Think its integuementary

  1. #1
    Location
    NEW ORLEANS
    Posts
    956
    Default Think its integuementary
    Medical Coding Books
    doc office booked this as 26115 and 21011 but i think its more integumentary codes 11623-hand and forehead 11643
    path report did come back as squamous cell carcinoma on both. Am I on the right path ?or is doc office corret ?

    26115

    PREOPERATIVE DIAGNOSES: Left hand mass and right forehead mass.

    POSTOPERATIVE DIAGNOSES: Left hand mass and right forehead mass

    PROCEDURE PERFORMED: Excision of left hand mass and right forehead mass.

    ASSISTANT: Gehr.

    OPERATIVE PROCEDURE: The patient was transported to the operating room and placed on the operating table in a supine position. MAC anesthesia was utilized. The left hand and right forehead were prepped and draped in a sterile fashion. The hand was infiltrated with 1% Xylocaine plain. An elliptical incision was made to encompass the lesion. Once this was excised, bleeding was controlled. The hand was infiltrated with 1% Xylocaine and elliptical incision was made. The wound was then closed with interrupted 3-0 nylon. Attention was then turned to the forehead where this was infiltrated with 1% Xylocaine with epinephrine. An elliptical incision was made there as well. The wound was closed on the forehead with 4-0 nylon. Blood loss during the procedure was minimal. The patient tolerated the procedure. He was taken to the recovery room in stable condition.

  2. #2
    Default
    I wouldn't use 11623 and 11643- no where in the procedure note does it give the diameter excised... (lesion diameter plus the most narrow margins required equals the excised diameter- I think you may be getting confused with the 3-0 nylon and 4-0 nylon is a surgical dressing the docs use when suturing the wound) unless the sizes are specified in the path report you have. Otherwise, I would down code these to 11620 and 11640- I'm on the same path as you. The report says 'lesion' not tumor-which are the codes they came up with and that leads me to skin- and since the path report says it was cancer- I would code it as malignant too. Hope this helps!

  3. #3
    Location
    Kingsport, TN
    Posts
    149
    Default
    I tend to agree with you. 26115 involves tumors excised from a resected area and layered closure which I do not see this in the documentation. Also, the physician description of the procedure closely matches the description in Coders' Desk Reference Procedures of 11620-11646 which states "the physician makes a full-thickness incision through the skin, usually in an elliptical shape around and under the lesion." Hope this helps.

  4. #4
    Location
    NEW ORLEANS
    Posts
    956
    Default
    thanks

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.