# Axillary Mass



## Mklaubauf (Apr 25, 2011)

HI,
When a subq. lesion is exicised from the axillary mass, what area of the body is that considered part of?

Would you consider it part of the thorax or arm or shoulder?

Thank you
Marci


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## Zina (Apr 28, 2011)

I have the same question right now! I guess it depends on the pathology...? I had one that was hidradenitis so I coded it appropriately. This one is "metatstatic breast ca extensively replacing a lymph node and extending into the surrounding tissue" so I'm going with 
38525. 

What was your pathology?


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## Mklaubauf (Apr 28, 2011)

Pathology stated subcutaneous tissue, lipoma.   So I'm looking at code 24071 because it was 3cm and dx. of 214.1


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## deborahcook4040 (Apr 28, 2011)

I consider it part of the thorax, since the "upper arm" area doesn't include the shoulder, which has it's own set of excision and biopsy codes. I figure if it doesn't include the top of the shoulder, then it wouldn't include the bottom, either. For that matter, since the shoulder area includes the head and neck of the humerus bone, and there's a code for soft tissue excision of a mass in the shoulder area, that one would probably be accurate as well. I'd still use the thorax, myself.


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## mjewett (Apr 28, 2011)

21555-21558 Axilla is part of the thorax


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## m.j.kummer (Apr 28, 2011)

21552 due to size and 214.1 due to path findings.


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## heathermc (May 3, 2011)

I have always thought thorax too, but at a general surgery auditing seminar last month, I was told to use shoulder area, the way she explained it made sense although right now it leaves me...but i did make sure to notate axillary = shoulder.


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## KimberlySherman (Feb 25, 2013)

*Could be either thorax OR shoulder OR breast?*



heathermc said:


> I have always thought thorax too, but at a general surgery auditing seminar last month, I was told to use shoulder area, the way she explained it made sense although right now it leaves me...but i did make sure to notate axillary = shoulder.


 
Depending on the part of the axilla, my unsubstantiated opinion is that it could be breast (tail of spence), thorax (a little higher up but still thorax - if you palpate your own axilla, you can feel how you are touching your chest area), or really high up in the axilla, part of the arm. 

It seems to me that for a general location, thorax and shoulder both make sense. It depends on where and how you palpate the area. Just my two cents. I wonder what a surgeon would say, other than just "axilla"?


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## sep5078 (Oct 12, 2016)

*I have submitted a quesiton to the AHA Coding Clinic for HCPCS about this...*

I have submitted a question to the AHA Coding Clinic for HCPCS for 'official' guidance for this question.

 It is a shame there is still no code specifically for the axilla.

 There are so many possibilities. But there needs to be some consistent advice on this.


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