# Excision of cyst in prepatellar area left knee



## paula f3 (Aug 25, 2011)

op note reads:
After successful general anesthesia , the left lower limb was prepped and draped in the usual manner.  After elevating the leg, a tourniquet above the left knee was inflated to 300 mmHG of pressure. The incision was carried through the skin,fascia and deep fascia was incised.  The fascial edges were mobilized on either side. The cyst was identiified. Circumferentail dissection was carried out and removed in total and sent to laboratory for examination. The wound was irrigated. The edges were infiltrated with marcaine.  The deep fascia was closed with 2-0 Vicryl and the skin with running 4-0 nylon. A sterile dressing was applied. The Tourniquet was released. The toes were viable and pink. The patient was transferred to the recovery room in good condition
pathology came back as Atypical spindle cell .
physician office coded this as 27347, no size of tumor was gven in op report, but path report gives size of 1.5x1.0x0.5 cm I was thinking towards 27337.
Would appreciate opinions.
Thank you
Paula


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## armen (Aug 26, 2011)

paula f3 said:


> op note reads:
> After successful general anesthesia , the left lower limb was prepped and draped in the usual manner.  After elevating the leg, a tourniquet above the left knee was inflated to 300 mmHG of pressure. The incision was carried through the skin,fascia and deep fascia was incised.  The fascial edges were mobilized on either side. The cyst was identiified. Circumferentail dissection was carried out and removed in total and sent to laboratory for examination. The wound was irrigated. The edges were infiltrated with marcaine.  The deep fascia was closed with 2-0 Vicryl and the skin with running 4-0 nylon. A sterile dressing was applied. The Tourniquet was released. The toes were viable and pink. The patient was transferred to the recovery room in good condition
> pathology came back as Atypical spindle cell .
> physician office coded this as 27347, no size of tumor was gven in op report, but path report gives size of 1.5x1.0x0.5 cm I was thinking towards 27337.
> ...



I would go with 27328 (Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramuscular); less than 5 cm). CPT 27337 is for subcutaneous tissue and in your case "The incision was carried through the skin,fascia and deep fascia"


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