# integumentary or musculoskeletal



## codedog (Jun 18, 2009)

Patient had an excision of 3 cm  benign lesion of buttock, with intermediate layered repair. An elliptical incision including the entire lesion was made with a skin knife. Cautery was used, and the lesion was excised down to the fascia of buttock. DO I code integumentary with a intermediate clousure or do i go into musculosketal since it was to the fascia. , ALSO are there any websites  I can go to to help me with similar cases .THANKS


----------



## FTessaBartels (Jun 19, 2009)

*Clarification needed*

I tell my doctors that if they are to code from musculoskeletal section they have to have gone *into *the fascia (or lower) ... not *down to *the fascia. 

It's a very small distinction but you need for the documentation to be clear.

F Tessa Bartels, CPC, CEMC


----------



## rthames052006 (Jun 19, 2009)

FTessaBartels said:


> I tell my doctors that if they are to code from musculoskeletal section they have to have gone *into *the fascia (or lower) ... not *down to *the fascia.
> 
> It's a very small distinction but you need for the documentation to be clear.
> 
> F Tessa Bartels, CPC, CEMC



Great point!!! I'm jotting this one down in my "notes".

Thanks Tessa,


----------



## codedog (Jun 19, 2009)

*Actual operative report*

DIAGNOSIS : CystiC Lesion, rt buttock  2.5 cm
Operation : Excision of cyst lesion , rt buttock, with intermediiate layer repair, 2.55 cm

Procedure:
After induction with general endotracheal anesthesia, ther patient was placed in prone postion. The right buttock was prepped and draped in usual fasion. The area infiltrated with a combination of 1% lidocaine and 0.25% marcaine

An ellipticalm incision was made with a skin knife. Using cautery, the lesion was incised., the lesion was noted to extend down to the anterior fascia of buttock. Oncw it was removed, intermediate layered repair was performed with 3-0 monocryl suture in deep subcutaneous, 3-0 monocryl in superficial subcutaneous, and a running 4-0 monocryl of skin. Sterile  dressings were placed. 
any suggestions


----------



## codedog (Jun 22, 2009)

SO this case would be integumentary?


----------

