# Removal of Keratinous Cyst



## bethh05 (Jan 6, 2010)

Op Procedure: The area was slightly infiltrated with 1% lidocaine with adequate anesthesia. Attention was focused on excision, the arm lesion was approached firstly. A #15 scalpel blade was used to make a small incision overlying this area. Hemostasis was assured with cautery. The lesion carefully dissected free with blunt dissection and handed off as the specimen. The wound was irrigated, hemostasis was assured, and then the skin reapproximated with interrupted 4-0 undyed Vicryl and interrupted 4-0 nylon.  
I am leaning toward the integ codes with layered closure, but the physician is coding from the musculoskeletal. Any thoughts?  Thank You Very Much

Path report states: Skin, Excision- Keratinous cyst


----------



## bench (Jan 6, 2010)

If the lesion did not reach the facial or muscle layer, the code should belong to integumentary. Integumentary coding is from epidermis/dermis and subcutaneous tissue. Per your op-report written here the lesion seemed to be integumentary only. HOpe this helps.


----------

