Catherine Posted Wed 24th of February, 2016 11:27:27 AM
Dr performed Open excision of right deep neck space tumor/skull base tumor 3 cm in size.
Dr would like to use 61605 but approach is not included. Approaches listed in same section 61590-61592 do not match what Dr performed. His approach was cervical to get to the lesion attached to the skull base.
I'm leaning towards 21554-22 or an unlisted code with notes.
Appreciate any help you can provide.
Path: Pleomorphic adenoma. Fragments of Benign lymph node.
SuperCoder Answered Thu 25th of February, 2016 03:31:25 AM
I think the most appropriate code that fits this scenario is CPT code 21556. Size of the tumor is 3cm.
CPT code 21554 could have been used for tumor size greater than 5cm.
CPT code 61605 cannot be used because provider used cervical approach to remove the deep neck tumor whereas per the code description auricular incisions are made (pre/post).
Hope it helps