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OPEN EXCISION OF MAXILLARY SINUS MASS

Suhel Posted Fri 21st of October, 2016 15:05:35 PM
Patient with history of maxillectomy for squamous cell carcinoma. Appearance of mass at tear trough area. Open biopsy and excision through the face thorugh her previous lateral rhinotomy incision. Lateral rhinotomy incision made. Skin flap elevated, dissected down and found friable mass at the tear trough and then going all the way posterior towards ethmoid cavity. Multiple pieces were removed and some tissue was suctioned away with cautery. Closed with deep and skin sutures. Would we use CPT 21013 or is there another code for something more specific to what was performed?
SuperCoder Answered Mon 24th of October, 2016 04:12:46 AM

Hi,

As per the above documentation, appropriate code would be 31225.

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