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Excision Mass

  1. Default Excision Mass
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    Hi,
    Can someone help me with the following surgery scenario?

    Procedure- Excision abdominal wall mass- ( benign lesion, per path report)
    Per op Report:

    Sharp dissection was carried down through the skin and subq tissues. The fascia was divided in the midline.The peritoneum was not opened. Dissection was carried along the posterior border of the right rectus abdominis. The mass involves the rectus abdominal muscle. The posterior fascia and peritoneum were left in situ and were not opened. Again, the posterior fascia and peritoneum were left intact.

    I was unsure if I should be in the section for excision of a deep mass or sub Q. I did questioned the doctor briefly, he said it was deep. So I went with code 22900. Would that be the appropriate code for this?
    Thanks!

  2. #2
    Default
    depending on pathology , if pathology says epidermal benign or lesion, than you cann't bill 22900. you have to bill 11400 codes depending on the size . if pathology says lipoma or soft tissue bengin then you can bill 22900 .

    Sirisha

  3. #3
    Default
    Quote Originally Posted by letisha View Post
    Hi,
    Can someone help me with the following surgery scenario?

    Procedure- Excision abdominal wall mass- ( benign lesion, per path report)
    Per op Report:

    Sharp dissection was carried down through the skin and subq tissues. The fascia was divided in the midline.The peritoneum was not opened. Dissection was carried along the posterior border of the right rectus abdominis. The mass involves the rectus abdominal muscle. The posterior fascia and peritoneum were left in situ and were not opened. Again, the posterior fascia and peritoneum were left intact.

    I was unsure if I should be in the section for excision of a deep mass or sub Q. I did questioned the doctor briefly, he said it was deep. So I went with code 22900. Would that be the appropriate code for this?
    Thanks!
    depending on pathology , if pathology says epidermal benign or lesion, than you cann't bill 22900. you have to bill 11400 codes depending on the size . if pathology says lipoma or soft tissue bengin then you can bill 22900 .

    Sirisha

  4. #4
    Location
    Milwaukee WI
    Posts
    4,466
    Default 22900
    22900 does NOT state that the tumor must be malignant. My Encoder Pro cross coder includes Dx 214.1 (Lipoma) and 215.5 (other benign neoplasm).

    So I think 22900 is the appropriate code.

    F Tessa Bartels, CPC, CPC-E/M

  5. #5
    Location
    ENGLEWOOD/DENVER
    Posts
    2,338
    Default
    I agree with Ftessa

  6. #6
    Default
    so when is it appropriate to bill for the lesions codes by size when its benign? i go by if its states lesion and so forth.

  7. #7
    Location
    CHERRY HILL
    Posts
    38
    Default
    The best way to tell is to read the report or ask the dr. to what tissue level was the excision. (ie: dermis, sub-q, fascia, muscle.) The 114XX codes are for excision thru the dermis. If the dr goes deeper (sub-q, etc) I would look to the 20000 series codes.

  8. Default
    I have a diagnosis code of 238.1 can someone help me with the procedure:

    Excision of mass, upper arm with excision through skin, subcutaneous tissue and fascia

    I have 24075 and 24076, am I correct?

  9. #9
    Location
    ENGLEWOOD/DENVER
    Posts
    2,338
    Default
    yes you are

  10. Default
    Thank you....

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