# neck mass



## codedog (Sep 21, 2011)

this case was booked as a 11422 simple excision  .dont agree, want to code 21556- excision of tumor of sof tissues of neck,but  path report came back as a thyroid  collid nodule- ,looking at 782.2 -subcutaneous nodules,---
.something does not seem right,is there enough info,?



PREOPERATIVE DIAGNOSIS:	Neck mass.

POSTOPERATIVE DIAGNOSIS:	Neck mass.

PROCEDURE PERFORMED:	Excision of neck mass.

ANESTHESIA:	General.

DESCRIPTION OF OPERATION:  The patient was brought to the operating room and placed in a supine position, adequate general anesthesia, prepped and draped around the neck in usual sterile fashion.  Incision was made in the crease overlying the mass, which was off the midline to the left above the cricoid process.  This incision was deepened through the skin and subcutaneous tissue, was infiltrated with 1% lidocaine and 0.25% Marcaine, 50:50 solution subplatysmally.  Circumferential dissection was done.  A cystic mass was located below the strap muscles on the patient's neck.  Circumferential dissection was done around this mass.  This was removed and sent to pathology for analysis.  Origins are not clear whether this is thyroid or not.  Hemostasis was obtained with electrocautery.  The wound was then closed in layers by re-approximating strap muscles, platysma, subcutaneous tissue, and then skin all in layers with absorbable suture.


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## JMeggett (Sep 21, 2011)

I would use 21556 for sure.  And I would choose ICD-9 784.2 since this isn't just subcutaneous.  I checked my crosscoder and the combo of 784.2 & 21556 do go together.  Nice job!

Jenna


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## codedog (Sep 21, 2011)

Wow for some reason I thought I was wrong


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