# Vulvectomy/ laser ablation



## karey (Jul 22, 2013)

[FONT=Arial,sans-serif]I originally coded 56620 and 56515. I am getting a denial stating 56515 is inclusive with 56620 although I am not finding any CCI edits. Can someone please look at this?[/FONT]
[FONT=Arial,sans-serif][/FONT] 
[FONT=Arial,sans-serif][/FONT] 
[FONT=Arial,sans-serif]PROCEDURE IN DETAIL: The patient was taken to the operating room where general anesthesia was obtained without difficulty.  A time-out procedure for safety was performed to confirm patient name, medical record number and procedure being performed.  She was carefully positioned in dorsal lithotomy in Allen stirrups.  Examination under anesthesia revealed the findings as described above.  The patient was then prepped and draped in the usual sterile fashion.  Her bladder was drained with a Foley catheter under sterile conditions.[/FONT]
[FONT=Arial,sans-serif]
[/FONT]
[FONT=Arial,sans-serif]The lesions as described were outlined with a pen. These areas were dissected with a scalpel, incising the skin and subcutaneous tissues but not into the deep pelvic fascia. This specimen was oriented when it was removed. Hemostasis achieved with the ESU. The site was irrigated. The perineal  skin was reapproximated by using 3-0 Dexon to reapproximate the skin edges. The LASER was used to ablate an anterior vulvar lesion to the right of the clitoris, and the bilateral labia minora where she had biopsy proven VIN1. Sulfasalazine cream was applied. The patient tolerated the procedure well and was then transferred to the recovery room in satisfactory condition. As the attending surgeon I either performed or immediately supervised the procedure. [/FONT]​


----------

