# The dreaded vaginal keloid scar/granuated tissue



## cwpierce (Mar 13, 2013)

Howdy all,

I wanted to stretch the mental envelope a moment and pose a question to ponder. I'm sure most of us have run across the op note where revision of a keloid scar or granulated tissue of the vaginal vault was performed. Finding a code that will accomodate this procedure is not an easy task. I am curious to know your thoughts on code 57135 - Excision of a vaginal cyst or tumor with a Dx of 623.8 - Other specified noninflammatory disorder of vagina.

I know that using a CPT for a cyst or tumor excision is stretching a bit but it would seem to be the closest representation of the procedure being performed other than using a -22 modifier on the primary procedure code for consideration of the additional work involved.

What are your thoughts and/or comments?

Thank you in advance for your time.


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## Emmy1260 (Mar 19, 2013)

11420-426 excision, benign lesion including margins, (except skin tag) scalp, neck, hands, feet, genitalia; by size

dx: 
701.4 Keloid scar
701.5 Other abnormal granulation tissue


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## Thouvenel (Mar 19, 2013)

It's not really a tumor, but can it be considered a foreign body?  57415?


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## cwpierce (Mar 20, 2013)

First, I may be incorrect but I thought the 10xxx Integumentary codes were for skin. When you mention genitalia on code 11420-426 I'm thinking the external genitalia...the skin portion and not up inside the vaginal vault. I don't think those codes would work for the internal portion of the organ but this is why I was asking the original question and appreciate that feedback as food for thought.

No, it is not really a tumor but I don't see it as a foreign body beings the scar tissue is formed by the human body so I was not considering it as a foreign body. I was more thinking that this was as close a code as I could come up with but wanted to see if I was stretching too much. Again, thank you for the feedback.


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