# 15830?



## herrera4 (Jul 6, 2011)

would the cpt 15830 be used for the removal of excess skin to help obliterate dead space? would the insurance even cover it since its usually for cosmetic purposes?TIA

The patient was brought to the operating room and placed in supine position. Following induction of general anesthesia, he was prepped and draped in the usual sterile fashion using ChloraPrep. The staples were removed from midline wound and using hemostat, the large hematoma/seroma cavity was entered.  Suction was used to suction free the hematoma/seroma. Remaining staples were removed and the abdominal wall subcu was debrided using gentle blunt dissection and irrigation. As noted above, the fascia was quite intact. There was some question about the viability of the skin edges on the right side. This was trimmed with tenotomy scissors. Given the large dead space, it was elected to excise the excess skin and subcutaneous tissue from the left side. An ellipse of skin measuring 4 x 20 cm was excised full thickness including the subcutaneous tissue. This allowed for a much tighter abdominal closure. Bleeding points were controlled with cautery when encountered and the wound was irrigated with Ancef solution.  Large Hemovac drain was then placed in the subcutaneous space and subcu was approximated using subdermal sutures of 2-0  Vicryl  followed by staples for the skin.  This was followed by dry sterile dressing and Tegaderm. The patient tolerated the procedure well and was brought back to the recovery room in stable condition.


----------



## mitchellde (Jul 6, 2011)

If you have a medically necessary diagnosis to go with it then yes, it were truely cosmetic then no.


----------



## herrera4 (Jul 6, 2011)

pre-op it was fascial dehiscence postop it was just excess skin taking up space? so not really medically neccessary right


----------



## DeeCPC (Jul 7, 2011)

herrera4 said:


> pre-op it was fascial dehiscence postop it was just excess skin taking up space? so not really medically neccessary right



I am leaning toward the ability to charge for this.  Why you ask...

"the removal of excess skin to help obliterate dead space"  Why is there dead space?

"the large hematoma/seroma cavity was entered. Suction was used to suction free the hematoma/seroma... Given the large dead space, it was elected to excise the excess skin and subcutaneous tissue from the left side. ... *This allowed for a much tighter abdominal closure."*  (there is your medical necessity)

You would use the complication/seroma code ICD-9 code.


----------



## mitchellde (Jul 7, 2011)

Yes I would agree with that.


----------



## Cindi Bartman (Aug 11, 2011)

*Imfomation regarding cpt 15830*

Requesting information regarding the CPT code 15830 relating to nonmedicare coverage


----------

