Wiki Excision Inguinal Lipoma

[MelBarclay]

I'm having a disagreement with our facility coders regarding the excision of an inguinal lipoma.

They've coded it using an integumentary code 11404. I've suggest either using CPT 22903 or an unlisted procedure (which I try not to use) because this was in the muskoskeletal system (soft tissue). I know the 22903 says abdomen and I don't like using unlisted but I feel like using 11404 just because there isn't an inguinal specific code is costing us and them money.

Any thoughts or suggestions?

Thanks!

 

[thomas7331]

I agree with you on this if the tumor was confined to the musculoskeletal soft tissue. The skin and subcutaneous excision codes that include 11404 are integumentary system procedures that are defined in CPT as "full thickness (through the dermis) removal of a lesion" and are intended for lesions involving the skin and subcutaneous tissue.

For a reference, I'd refer you to the CPT Assistant article from September 2018 which I think spells this out quite clearly, and states that the musculoskeletal system codes are for tumors confined to tissue below the skin: "Subcutaneous soft connective tissue tumors involve the simple or marginal resection of tumors confined to subcutaneous tissue below the skin, but above the deep fascia. These tumors are usually benign and can be resected without removing a significant amount of surrounding normal tissue. Simple or intermediate repair is included and not reported separately."

 

[MelBarclay]

I agree with you on this if the tumor was confined to the musculoskeletal soft tissue. The skin and subcutaneous excision codes that include 11404 are integumentary system procedures that are defined in CPT as "full thickness (through the dermis) removal of a lesion" and are intended for lesions involving the skin and subcutaneous tissue.

For a reference, I'd refer you to the CPT Assistant article from September 2018 which I think spells this out quite clearly, and states that the musculoskeletal system codes are for tumors confined to tissue below the skin: "Subcutaneous soft connective tissue tumors involve the simple or marginal resection of tumors confined to subcutaneous tissue below the skin, but above the deep fascia. These tumors are usually benign and can be resected without removing a significant amount of surrounding normal tissue. Simple or intermediate repair is included and not reported separately."

Thanks for the reference; this is just what I needed!