Ob-Gyn Coding Alert

Question: A patient presented with a line of condylomata in the posterior fourchette, just inside the labia in the vagina. She also had a lesion just anterior to the urethral meatus. The ob-gyn vaporized both the lesion and condylomata using a CO2 laser. Additionally, the ob-gyn excised large-sized multiple condylomata around and into the rectum and sent them for diagnosis. He vaporized the remaining ones. After the excision and vaporization, the ob-gyn coated the area with Silvadene and the patient returned to recovery. How should I code for the lesions and excision? Florida Subscriber Answer: You should use two codes for the vaporization: 56515 (Destruction of lesion[s], vulva ...) for the lesions of the vulva (posterior fourchette and urethral meatus), and 46924 (Destruction of lesion[s], anus [e.g., condyloma, papilloma, molluscum contagiosum, herpetic vesicle], extensive [e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery]) for the anal lesions. For the excision, make sure you [...]