Wiki 54060 vs 11624

Excision of a penile mass.

The patient had a large roughly 4 centimeter mass emanating from the inferior aspect of the right glans, this was partially involving the meatus. Additionally there was a 5 mm firm nodule on the left aspect of the meatus as well. The placed a suprapubic tube and then attention was directed to the penile masses. A tourniquet was applied by wrapping the base of the penis with a Penrose drain. We proceeded to excise the mass trying to maintain an adequate margin incising to deep into the glans tissue and the meatus. The 1st mas was excised and sent to pathologic analysis. Using electrocautery and blunt dissection we also excised the 2nd smaller mass from the distal glans adjacent to the left aspect of the meatus. We proceeded to close each defect independently with running 3-0 Vicryl stiches at the base of the defects followed by interrupted horizontal mattress sutures 3-0 Vicryl. Pathology both came back sarcoma.
 
I am questioning this because penile cancer is a payable code for the 5 code also. I normally only code for the 5 code only when it is a condyloma, molluscum, contagiosum, herpertic vesicle.
 
Well that sounds like a very detailed and deep excision involving more than superficial structures. Don't have my books out anymore but I'd look further than a skin-level code. Good luck.
 
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