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Linda Posted Tue 28th of February, 2012 21:29:07 PM

Regarding deep dermis/skin closure. Would this ever be considered layered when deep subcu not mentioned? Also,
since this was a mass but not a tumor, would this be totally integumentary (11406) instead of a musculoskeletal code (tibial muscle was mentioned)?
Based on path, would the diagnosis code 709.3 or 782.2?

Preop/Postop Diagnosis: Left Leg Mass (Suspect Gouty Tophaceous Deposit)

Path: Polarizable crystal deposits consistent with gout

The skin was incised sharply and then skin sharply dissected off the
underlying mass which was immediately apparent after penetrating the
deep dermis. The mass was multilobulated with rock-hard induration
in many places. Sharp dissection technique was used to get around the mass and develop a plan between it and the underlying tibial
musculature. The deep dermis as then approximated with buried
interrupted sutures of 2-0 Vicryl and the skin closed with simple
interrupted sutures of 4-0 nylon.

SuperCoder Answered Tue 28th of February, 2012 22:09:21 PM

27632 is the correct code for the Px mentioned. The mass is in the SUBQ(not intervening in the muscle) which involves dermis. Dx would be 782.2

Linda Posted Wed 29th of February, 2012 15:00:48 PM

Since this is a mass and not a tumor, would this code be appropriate? 782.2 is not an approved code for
27632 for some reason. But neither is 709.3. Do you have any ideas?

And regarding deep dermis/skin closures, would this ever be considered layered since the intermediate closure
specifies deep subcu?

SuperCoder Answered Wed 29th of February, 2012 17:15:39 PM

Deep dermis/skin closure in your case can be considered as Intermediate as subQ invloves deep dermis. This is a judgement call. Regarding the Dx you can use 239.2 for that.

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