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Linda Posted 6 Year(s) ago

Posted 1 month ago #

Does anyone know the cpt code for the excision of a perineum sinus
tract on a male patient?
Snayhil Rana
Posted 1 week ago #

I would prefer to use CPT code either 46050 or 46270 for the given scenario. There is no exact CPT code for "excision of a perineum sinus tract on a male patient”. The closest options are 46050 or 46270 (depending upon the situation).
I need detail documentation to assist you precisely.
Linda Lentner
Posted 1 week ago #

Preop diagnosis/Postop diagnosis: Hidradenitis of the perineum

Brief HX: The patient is a 37 year old male diabetic with a history of recurrent draining sinus tracts at the base of the scrotum. These appear to be related to process of hidradenitis of the perineum. He is taken
now to surgery for excision of this sinus tract.

Path: Granulation tissue with abscess formation, fibrosis, and findings consistent with fistula tract.

Op Note:
The patient was brought to the operating room where in the supine position general endotracheal anesthesia was
administered after which the patient was placed in the dorsal lithotomy position. Perineum was prepped and
draped in usual sterile fashion. Operation commenced with local anesthesia along an intended line of incision involving an ellipse that included the sinus tract. The skin was incised sharply with #15 scalpel blade. In using countertraction with Allis clamps, the skin was incised full thickness along the length of the perineum and submitted as a specimen. The wound was fairly hemostatic. Small bleeding vessels were arrested with electrocautery. The subcutaneous tissue was then approximated with buried interrupted sutures of 3-0 Vicryl and skin closed with simple interrupted sutures of 4-0 nylon. The wound was dressed with bacitracin, Xeroform, dry sterile gauze and Tegaderm dressing.

SuperCoder Posted 6 Year(s) ago

Go with 11470. This is a Dx based CPT which covers the scenario. To treat Hidradenitis excision of perineum sinus tract is done.

Linda Posted 6 Year(s) ago

That's what I did. Thanks for the confirmation.

Posted by Linda, 6 Year(s). There are 3 posts. The latest reply is from Linda.

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