General Surgery Coding Alert
19260 Captures Chest Wall Tumor Pay
Question: The surgeon dissects down through the skin, subcutaneous tissue, and latissimus dorsi muscle to expose a subcutaneous mass. The surgeon removes the mass by blunt dissection, including some surrounding soft tissue and intercostal muscle. The surgeon closes the muscle and subcutaneous tissue with sutures, followed by skin sutures. Should I report this as 13100?
Answer: No, 13100 (Repair, complex, trunk; 1.1 cm to 2.5 cm) does not adequately describe your surgeon’s work.
Instead, you should report 19260 (Excision of chest wall tumor including ribs). Although the surgeon performs layered closure as you’d expect for a complex repair (such as 13100), that’s not the most descriptive code.
The focus of the procedure is removal of a chest-wall mass. The surgeon’s work includes an incision into the chest wall, moving the fascia and chest muscles, and removing the tumor, including surrounding soft tissue and intercostal muscles. If the surgeon had removed any rib(s) due to tumor involvement, that would also be included in this procedure.
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General Surgery Coding Alert
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