# Incision and Excision Of Sebaceous Cyst



## Ravikirann (Sep 15, 2015)

Hi All,

This is Ravi, the below OT notes is from our hospital.The doctor has performed both Incision and Excision Of the *Sebaceous Cyst of the Back*.What CPT i can charge.

Can I charge both 10060 and 114xx series with 59 modifier.by checking the below notes please help me.


Through an elliptical incision; The punctum, where the overlying skin is tethered to the cyst,
is adjusted to be in the centre of the ellipse. 
The length of the ellipse approximates the diameter of the cyst.
First the skin ellipse is incised, with care taken not to enter the cyst with this initial incision. 
The plane is then developed immediately outside the cyst wall. Dissection is initially started at the two
ends of the ellipse, ensuring that the skin incision is full thickness into subcutaneous fat.
 Artery forceps applied to the freed ends of the ellipse and a skin hook placed under the
lateral skin edge can be used to retract and counter-retract to identify the plane, 
and place it on stretch for sharp dissection; Blunt dissection, with forceps or scissors,
 is also employed
Closure of skin using interrupted 3/0 monocryl

Thanks In Advance
Ravi


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## CodingKing (Sep 15, 2015)

This link from a similar answer to a sebaceous cyst excision 

https://www.aapc.com/memberarea/forums/showpost.php?p=28360&postcount=4

The physician did not do both, they either did one or the other. The elliptical incision is the cut thats made to excise a lesion. If you have the Professional AMA version of the CPT book look at the diagrams and you will see what this cut looks like. 

Looking at the notes, he took care to make sure not to puncture the cyst wall. I&D would involve purposely puncturing the cyst to drain it. Even if he nicked it on accident it woudln't make it and I&D


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## Ravikirann (Sep 16, 2015)

Thank You


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