# excision of dermal inclusion cyst code?



## SLELISON (Nov 20, 2008)

Hello everyone.  I have a question that I know you all can help me with.  I have an op note for excision of dermal inclusion cysts on the anterior trunk with layered closure x3.  I was looking at 22900 but I think I need to stay in the int. section.  Can I code for the removal and layered closure?  How would you guys recommend coding? 

The op note reads as follows:

The pateint was taken to the OR and placed in the supine position oundergoing anesthesia.  The region was sterilely prepped and draped and anesthetized with .25% marcaine with epinephrine after which elliptical excision in oblique orientation was performed to minimize skin excision and tension of the wound.  After excising the lesions, hemostasis was obtained with bovie electrocautery.  The cavity was treated with betadine. 2-0 vicryl was used in the deep dermal layers to approximate the deep dermal layers and 3-0 monocryl was used to close the skin in subcuticular technique.  Mastisol, steri-strips, and sterile dressings were placed.  The patient was awakened from anesthesia and taken to the recovery room in stable condition.

Path report says ruptered epidermoid cyst with acute and chronic inflammation. received in formalin is a 2.4 x 0.9 cm ellipse of skin excised to a depth of 0.7 cm.  The epidermis is tan with 3 tan-grey raised papules which are separate and range from 0.2 x 0.2 x 0.1 cm to 0.4 x 0.4 x 0.1 cm.


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## magnolia1 (Nov 20, 2008)

I would stay with the integumentary system, with an intermediate closure.


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## magnolia1 (Nov 20, 2008)

Actually, after re-review, I don't think I would go with an intermediate closure.


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