David Posted Mon 09th of June, 2014 15:45:32 PM
How would i code excision of multiple large scrotal sebaceous cysts done in the OR. This was an open procedure.
SuperCoder Answered Tue 10th of June, 2014 09:34:05 AM
Turn to codes 11420-11426 (Excision, benign lesion including margins, except skin tag [unless listed elsewhere], scalp, neck, hands, feet, genitalia ...). The code you select depends on the documented diameter of the total amount of scrotal skin the urologist had to remove in removing the cyst, not the diameter or size of the lesion itself.
Tip: If the excision was complicated or “unusual,” CPT directs you to add modifier 22 (Unusual procedural services) to indicate that the urologist spent additional time and/or effort on the procedure.
Also, if the closure of the defect involved more than a single layer, you may be able to add an additional code to describe the repair of the defect from the code series 12041-12047 (Layer closure of wounds of neck, hands, feet and/or external genitalia ...) for layered closure or from the code series 13131-13133 (Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet ...) for a complex repair, such as a complex tissue re-arrangement.
Diagnosis: Depending on the clinical findings, there are many diagnosis codes you may use when removing skin lesions. In this case, ICD-9 code 706.2 (Sebaceous cyst) would be the correct diagnosis. However, for many carriers it is not enough to link the procedure codes (11420-11426) to a correct payable ICD-9 code.