# new coder needs help with CPT -  Any help



## ggparker14 (Feb 2, 2011)

Need help with CPT. Any help is appreciated. Thank you.

operation: bilateral surgical reduction of labia minora.

With the scalpel the excess of the skin of the labia minora was excised completely and the labia was sutured back with interrupted 3-0 Vicryl. The same thing was done on the other side.


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## preserene (Feb 2, 2011)

56620-50, and 12001-12006 as the size meets out.
hope this helps.


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## pruth1660 (Feb 4, 2011)

56620 does not allow 50 modifier


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## preserene (Feb 5, 2011)

Well, I did not know it.  Is it because I used 2009 manual  or not aware of the edits or so? I ask  honestly. 
But Vulvectomy code 56620  is for any one side only (and partial). Then how do you assign x2 ? or report twice? Can I  have the  rulings please?
Or any one can throw some more lights on this?
But at the same time there is a bilateral code with modifier -50 , for a RADICAL PROCEDURE(with 56640)!?


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## 1ASC-CODER (Feb 5, 2011)

Hi 

May  I asked of the DX? this might help guide your CPT choices, each of the 56620-56640 codes include removal of premalignant or malignant lesions.

56620- is one side and may include removal of other areas. 56625 is all areas. Same for 56630 - be mindful of partial, complete, radical partial, radical complete.

If the op is not complete refer to the DOCTOR or the path can guide you as to the depth and extent of the excison and malig. but always use the op note and the clarifiy with the doctor.

If you are able to get this infomration we can discuss the code options. The excision codes might be the other choices. 

Florence


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## preserene (Feb 5, 2011)

Labia minora is one of the major parts of Vulva. 
Other parts are Labia majora, mons pubis, clitoris, bulb of vestibule, vulval vestibule, greater and lesser vestibular glands, and the opening of the vagina.

So excision of  labia minora  merits for Vulvectomy- Partial. (simple)- 56620.

My question is why not 56620 with a modifier 50 for Bilateral; and my request is for the guidelines reference "not to use Bilateral code modifier 50" as Bruth claimed. 

VULVA means singular and VULVAE  is the plural form. 
I ask this for a better  understanding of coding the scenario not for anything else, and to correct it, if I am wrong in coding with the modifier; and the right way of coding the situation. 
Thank you


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