1. Lisa Rodriguez
   Posted 1 year ago #
   

   My physician performed an excision due to a painful clotted vein in the lower extremity. I can not find a code specific to this type of Sx. Does anyone know of something that would be appropriate other than "28899" He thought maybe "27632" might work. Any thoughts?

2. SuperCoder
   Posted 1 year ago #
   

   Did the exicision go through the fascia? That is the depth requirement for using the musculoskeletal system excision codes. Excisions that are less deep fall under the integumentary excision codes. Code 27632 has been renumbered for CPT 2010. The note directs you to 27613-27647. The alphabetical index directs you to 27630 for excision, leg.

   I'm asking the General Surgery Coding Alert editor to weigh in on this.

   Jen Godreau, CPC, CPEDC
   Content Director, Supercoder.com

3. SuperCoder
   Posted 1 year ago #
   

   Unfortunately, there really isn't enough information here for me to give a solid, exact answer. Basically, I'd need to know: Was the biopsy performed open or laparoscopic? Was it a needle biopsy? Was the entire mass removed? What kind of cells did they find?

   I asked General Surgery Coding Alert consulting editor, Marcella Bucknam, to weigh in and she said: "One would expect liver tissue considering the area so I’m inclined toward code 47001. But there’s no way for me to know for sure. The coder should probably talk to the surgeon if that’s possible. Sometimes biopsies don’t return the kind of result we think they will even when the surgeon is pretty sure what he’s seeing. If he’s really sure it was a lymph node, she would need to use the unlisted lymph code depending on whether it was done open (38589) or lap (38589)."

   I hope that helps you get started. Good luck!

   Leesa A. Israel, CPC, CUC, CMBS
   Executive Editor, The Coding Institute
   leesai@codinginstitute.com

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