I am new to coding for wound surgery and am having some confusion with how to interpret the measurements in the provider note for coding for the wound excision and wound closures. Specifically, how to read the measurements in the note from the provider. For instance, in the example below for coding the excision of cyst I am choosing code 11406 for the size of 11cm of the wound. 7 for the largest diameter plus 2+2 for the margins. So 7cm+2cm+2cm=11cm. I am thinking I can bill for intermediate closure as it says the wound was opened in layers and the subcutaneous were approximated with Vicryl 4-0 and subcuticular w/ Monocryl 4-0 For the intermediate closure I would use 12035 for 18cm I am adding 7cm+7cm+2cm +2cm=18cm Am I adding up the measurements correctly? Thank you for any assistance.
Procedures: Surgical excision of large chronic infected sebaceous cyst on lower back.
Large chronic infected sebaceous cyst on lower back. Size: 7.0 x 7.0 cm 2.
Procedure Details
The risks, benefits, indications, potential complications, and alternatives were explained to the patient and informed consent obtained.
Lidocaine 2% with epinephrine 15 cc was injected locally and field block around the cyst was created.
The Cyst and surrounding area was given a sterile prep using chlorhexidine and draped in the usual sterile fashion.
Transverse incision was made using surgical scalpel # 15.
Open in layers and the whole cyst was excised.
Hemostasis was obtained using Bovie.
Subcutaneous tissues were approximated using Vicryl 4-0.
Skin closed subcuticular using Monocryl 4-0.
Steri-strips and 4x4 dry dressing were applied.
Procedures: Surgical excision of large chronic infected sebaceous cyst on lower back.
Large chronic infected sebaceous cyst on lower back. Size: 7.0 x 7.0 cm 2.
Procedure Details
The risks, benefits, indications, potential complications, and alternatives were explained to the patient and informed consent obtained.
Lidocaine 2% with epinephrine 15 cc was injected locally and field block around the cyst was created.
The Cyst and surrounding area was given a sterile prep using chlorhexidine and draped in the usual sterile fashion.
Transverse incision was made using surgical scalpel # 15.
Open in layers and the whole cyst was excised.
Hemostasis was obtained using Bovie.
Subcutaneous tissues were approximated using Vicryl 4-0.
Skin closed subcuticular using Monocryl 4-0.
Steri-strips and 4x4 dry dressing were applied.