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Wiki cpt for excision of rt index distal phalanx exostosis

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Rufus186

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I am having trouble confirming the correct cpt for the excision of a index distal phalanx exostosis. The surgeon wants to use 26210-excision or curettage of bone cyst or benign tumor. The path report confirms exostosis which would be benign bone. I do not see any other possibilities and I have exhausted my resources, any help would be appreciated. Thank you in advance.
 
Op report reads as follows incision made sharply, care taken to stay dorsal to the neurovascular bundles. The mass was identified appearance of a large benign exostosis. Subperiosteal dissection was then undertaken with a beaver blade to expose the lesion, it was amputated at the site of origin. Site of origin trimmed with rongerr and smoothed with rasp to normal contour. Wound irrigated.

My concern was this is not a cyst or tumor as stated per cpt 26210. Thanks again I appreciate the input.
 
I still believe the correct code is 26210.

Per CPT Assistant, April 2012 Page: 17 Category: Frequently Asked Questions:

Surgery: Musculoskeletal

Question:

A parenthetical note under code 27640 states, "For exostosis excision, use 27635" (Excision or curettage of bone cyst or benign tumor, tibia or fibula). Can it be inferred that these codes may be used for any excision of exostosis or does the surgeon have to have documented that the patient had a bone cyst or benign tumor?

Answer:

An exostosis is a benign tumor; therefore, it is appropriate to report code 27635, Excision or curettage of bone cyst or benign tumor, tibia or fibula.
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Based on the fact that the CPT book directs you to use 27635 for an exostosis excision of the tib/fib, I feel that this guidance would apply across the board. Therefore, an exostosis excision of the distal phalanx would be coded as 26210.
 
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