Ob-Gyn Coding Alert
Gain Insight Into This Granulation Tissue Removal and Closure Scenario
Question: Patient had a Nexplanon with nonhealing incision and granulation tissue. She had an outpatient procedure done of removal of Nexplanon, removal of granulation tissue, and closure of incision. An elliptical incision was made around the granulation tissue to create a clean margin. Tissue was removed, and the Nexplanon was removed. The incision was closed with subcuticular stitches of 3-0 vicryl and with interrupted sutures with 4-0 Monocryl. I know the Nexplanon removal is 11982, but I’m lost on the granulation tissue removal and closure. Everything I’m looking up says use the unlisted 58999 code. Is there no other code for this? Idaho Subscriber Answer: You should add a modifier 22 (Increased procedural service) to 11982 (Removal, non-biodegradable drug delivery implant) and include documentation supporting the difficulty in the additional work.
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