Outpatient Facility Coding Alert
Separate Charges for Pilonidal Cystectomy and Z-plasty Could Apply
Question: A proctologist treated a patient for pilonidal cystectomy. A plastic surgeon was involved with the procedure to close the cyst via Z-plasty (he removed an 8 sq cm area of skin from the patient’s trunk). How do I code this procedure?
Answer: Several codes could be considered for the cystectomy, depending on how complicated the removal was. Because a plastic surgeon helped with the case, you might select either 11771 (Excision of pilonidal cyst or sinus; extensive) or 11772 (… complicated) for the proctologist’s work.
The correct code for the plastic surgeon would be 14000 (Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less). More detailed descriptions of the code note that the surgeon might use flaps, Z-plasty, or similar techniques to complete the procedure.
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Outpatient Facility Coding Alert
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