# 27337 or 11406



## codedog (Mar 30, 2011)

I WANT to go with cpt code 11406 but something is telling me to use 27327. Also PATH REPORT SAID no skin is present with the specimen,but doc reports that lesion is  just below the skin. Path  report  came back as a deep penetraing dermatofiboma-so would  27337 be the right the right choice?



POSTOPERATIVE DIAGNOSIS:  Left thigh mass.
OPERATION:  Excision of left thigh mass, 3 to 4 cm.
D.
ASSISTANT:  None.
ESTIMATED BLOOD LOSS:  Minimal.
LAP SPONGE AND NEEDLE COUNT:  Correct.
PROCEDURE IN DETAIL:
After appropriate informed consent was signed, the patient was taken to the operating room, was transferred to the operating table, and underwent general anesthesia with successful endotracheal intubation.  The area was prepped and draped in the normal fashion.  The patient had been examined by me in the preoperative holding area.  A time-out had been called to identify correct patient and correct procedure.  Preoperative antibiotics were given prior to skin incision.  Incision over the area was made in Langer's lines along the axis of around 4 to 5 cm.  Dissection was carried out through the skin and subcutaneous tissue.  The entire mass that appeared to be hard with surrounding fat was removed.  Excellent hemostasis was noted to be obtained.  The wound was closed with 3-0 Vicryl pop-offs and nylon for the skin.  The patient tolerated the procedure well and was transferred to the recovery room in stable condition.


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## Jamie Dezenzo (Mar 31, 2011)

*dx 216.7*

I'm going towards 11406 since neoplasm, skin


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## SS62 (Apr 6, 2011)

Hi
Correct me if I am wrong, please...wouldnt the following statement  "_Dissection was carried out through the skin and subcutaneous tissue"._  qualify this for 27337?  also path stated "_deep penetraing dermatofiboma_"    IMHO...Thanks...


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## Jamie Dezenzo (Apr 12, 2011)

CPT ASST.
Year: 2011

Issue: January 

Pages: 9-10 

Title: Coding Consultation: Questions and Answers 

Body: Surgery: Integumentary System

Question:The patient has a large 4-cm sebaceous cyst in the middle of the back. The incision was made right over the cyst, cutting through skin and subcutaneous tissue. Should this be reported from the Integumentary or Musculoskeletal system codes?

Answer:The appropriate code for this procedure (excision of benign lesion codes 11400-11406 of the Integumentary subsection) would be based on the size of the excised diameter. These tumors originate from the dermis or adnexal structures and are not considered soft tissue tumors, even though they may protrude into subcutaneous tissue.

I'm looking at the dermatofiboma the same way, just my thought ....


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## ASC CODER (Apr 12, 2011)

If it starts ON the skin and could go subcu then use the integ. codes. 

If it is under skin and goes subcu like example lipoma etc... then use the musc. codes


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## EMS7775 (Apr 12, 2011)

I would go with 27337.

Ebony Ratclffe, CPC


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## bethh05 (Apr 12, 2011)

Dermatofibromas are benign skin growths, I would stick with integumentary codes.


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