# Excision that has been confused!



## ksb0211 (Feb 23, 2011)

*Excision that has me confused!*

Just hoping for some feedback.  Preop dx is for mass, postop is for presumptive neuroma, but the pathology came back as BENIGN SCHWANNOMA, MEASURING 2.5X2.5X2 CM.  One coder suggested using 64774 (excision of neuroma)!  Argh.  LOL

Scrubbed op report:

PREOPERATIVE DIAGNOSIS
Mass posterior calf.

POSTOPERATIVE DIAGNOSIS
Presumptive neuroma sural nerve.

PROCEDURE/OPERATION
Excision.

DESCRIPTION OF PROCEDURE
... Incision was made over this mass. We dissected it out. It looked like this was about a 2 cm mass that came off of the sural nerve. We skeletonized it and removed the neuroma in its entirety but left the nerve intact. At this point we replaced the nerve back within the area of the leg and then closed with deep sutures of 4-0 Vicryl followed by running subcuticular suture of 4-0 Vicryl augmented with one interrupted mattress suture. The patient tolerated the procedure quite well.


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## susanp (Feb 23, 2011)

I agree that code 64774 could be used for the procedure described.


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## Hopp (Mar 11, 2011)

I also agree with the code 64774
Deb, CPC


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