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ADENOCARCINOMA

Lina Posted Mon 13th of October, 2014 14:14:20 PM

Please need your help on coding this:

1. Excision of the hair bearing area of the right axilla with underlying mass.
2. Dissection of the lymph node from axillary artery and vein.
3. Frozen section of the mass.
4. Excision of mass from right lateral chest wall.
5. Excision of mass from deltopectoralis region of right side.

I got
38740
88333
21552
24075

SuperCoder Answered Tue 14th of October, 2014 03:08:47 AM

Thanks for your question!

Suggestions is based on one line description of procedure in your query, you should review procedure performed in detail to get correct CPT codes. Please note, your query does not reflect radical resection, however if radical resection of adenocarcinoma is being done, then you need to select Radical resection codes from the respective CPT code ranges mentioned below.

1. Excision of the hair bearing area of the right axilla with underlying mass. - Axillary means the area near or under the armpit. It is important to pick a correct code while submitting claim for lesion excision.You have to figure out type of lesion, depth of lesion, along with the size of lesion. So as the lesion has been excised deep under the fatty layer, might be reached to sweat gland, so you have to look 116xx, 240xx series for correct CPT code. If lesion size is less than 3 cm, code 24075. If greater, code 24071. Choose appropriate code based on type, size, depth, and location. sometimes you have to see for 11451 if you are removing lesion in axillary area for hidradenitis and if complex repair is being performed.

2. Dissection of the lymph node from axillary artery and vein- You can code 38740 for this procedure, however if complete or radical resection documentation is found, code 38745.

3. Frozen section of the mass.- This service should be billed by pathologist and not the surgeon. Surgeon removed the frozen section piece and hand it over to pathologist for his cytologic consultation during surgery. If surgeon performed the cytologic evaluation himself (very rare case), he may bill this service 88333.

4. Excision of mass from right lateral chest wall - You can report 21555 for chest wall mass excision. Pay attention to the size of the lesion, if its greater than 3 cm, code 21552, 21556, or 21554.

5. Excision of mass from deltopectoralis region of right side- You can report 24075 for subcutaneous tissue mass from shoulder area and if its excised deep (subfascial, intramuscular), you need to code 24076. Also pay attention to the size of the lesion excised and select appropriate CPT code.

Hope this answers your query!

Lina Posted Mon 17th of November, 2014 12:58:20 PM

Thanks for your respond
so with all your help
I got this
24071
38745
21555
24075
Do I need to apply modifiers here?
Thank you again

SuperCoder Answered Fri 21st of November, 2014 04:01:51 AM

Thanks for your query.

Assuming CPT codes were issued after reviewing operative report documentation in detail.

There is bundling between 24075 and 24071 per NCCI edits. Code 24075 is a column 2 code for 24071 , but a modifier (59) is allowed in order to differentiate between the services provided.

Please review the documentation to see if subcutaneous mass excision (24075) is done via same incision as 24071, then we would not code 24075 separately. Please review the documentation to see if there are pointers to support 24075 as separate and distinct procedure from 24071. If 24075 is separate and distinct, we would code it separately with a 59 modifier.

Hope it clarifies. If there are any further queries, please let us know.

Thank you!

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