# coding help....



## mgord (Mar 12, 2009)

Does anyone know of a code that can be used for Excision of Chronic Sinus Tract of Buttock? At first I thought of using the 11770-2 but the doc said no that wasnt what he did. 

Op note says: Patient placed supine under general endotracheal anesthesia. Placed in the lithotomy position. At the junction of the right buttock and perineum and to the right of the anus the chronic sinus tract was identified and had previously been marked. Area prepped and draped in normal sterile fasion. An elliptical incision was made to include the previous scar in the sinus tract. We then tracked that down all the way to the pelvic floor musculature. This included the entire sinus tract which clearly had some hypertrophic granulation tissue throughout. The wound was copiously irrigated and hemostasis assured. We then closed the deep tissues all the way up to the dermis with interrupted 3-0 Vicryl sutures. Steri-stripped skin and sterile dressing applied. Pt returned supine and awakened. Returned to recovery in stable condition. All counts correct.


Can anyone offer any suggestions??
Thanks!!!!!!


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## MAIRA PATTERSON (Mar 12, 2009)

Hi  Mary Beth 

I Was Looking At The Following Codes Under Surgery/anus/incision46020-46330. 

The Description That You Give Is Not Very Clear. If You Have More Info I Like To Help  You Since I Work With A General Surgeon.

Keep Me Posted.
Maira


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## Leanne (Mar 13, 2009)

Have you looked at:

46270 Surgical treatment of anal fistula (fistulectomy/fistulotomy); subcutaneous


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## ginacrowe (Mar 19, 2009)

*OB billing*

I have just picked up a large family practice group that does OB.  I have never done OB billing before other than the usual PAP/Pelvic stuff.

I do know that you can not bill the insurance until the baby is born.  Is there a standard general CPT code that should be used everytimg the patient comes in?  Also, how do you bill for the initial OB?  What if the patient comes in during that time for a sorethroat?  Would you bill an office visit with a mod 24?

Thanks so much for the help!
Gina CPC


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## mgord (Mar 24, 2009)

I didnt think 46270 would be appropriate. The pt doesnt have an anal fistula. Its a sinus tract of the buttock - when I look up sinus tract it redirects me to Fistula and I used 686.9 Fistula, Skin.


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