# Excision benign tumor with subcutaneous flap closure



## B_Porter (Oct 1, 2013)

I am stumped with this procedure: excision left flank mass 7cm with subcutaneous flap closure (path confirms benign tumor)

Full-thickness incision performed and mass excised all the way down to fascia with electro cautery; skin really did not come together very easily and for this reason subcutaneous flaps were elevated circumferentially back about 5cm were able to pull the deep dermal tissues together with interrupted sutures then the skin was closed with running 4-0 vicryl subcuticular.

I don't know if I should just code 11406 (excision benign lesion including margins except skin tag trunk arms or legs excised over 4.0cm) with intermediate repair 12034 (think I would add the size of excision plus size of expansion for closure) or 15734 (muscle, myocutaneous/fasciocutaneous flap trunk)

Am I way off on this?


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## FTessaBartels (Oct 15, 2013)

*NOT a skin lesion*

If this was all the way down to fascia, it's not a SKIN lesion

You are probably looking at 21931. I don't think you have sufficient documentation for a muscle flap, but I'd add a -22 modifier for the extra difficulty closing.

Hope that helps.

F Tessa Bartels, CPC, CEMC


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