Wiki Forearm masses-clinically a lipoma

[codedog]

Would you code this 25071 x2 or 11403 x 2
here is operative report
OPERATION - dissection was carried down through skin and subcutaneous tissue after making an incision in the area for around 2-3 cm. It appeared to be a lipoma. The entire sac with surrounding tissue was removed. It was sent to pathlogy. Skin was closed with 3-0 nylon. On the medial side, the exact same thing was done. This was noted to be about 3cm. Dissection was carried down through skin and subcutaneous tissues. The entire mass with surrounding tissue was removed. The skin was closed with 3-0 nylon. A sterile dressing was placrd .

I want to code 25071 -CPT code in book says subcutaneous 3 cm or greater
but I seem to have a hard time looking at key words that leads me to 25071 or 11403- can someone explain what they would code it and why ?

I been to some forums in this aapc and it seems some people do get confused on this subject , so someone breaking It down may help
THANKS

 

[cmartin]

To me it sounds like 25071 (or 25075 depending on size) - they're dissecting down thru skin and subq tissue b/4 they get to the mass/lipoma. It always helps to be familiar with the way the particular provider phrases things, but I think it reads as though the tumor is in the subq tissue, not the skin, so 25075/25071 rather than 11403/11404; path report should clinch it for you.

 

[codedog]

thanks- path report read received in formalin is segment of adipose tissue measuuring 2.4 x1.8 x 0.9 cm . The specimen is serially sectioned to reveal usual fatty cut surface ans spcimen is entirely covered with very thin membranous tisue and it went on to say same for other specimen -thanks

 

[Mklaubauf]

There is a very good article in CPT Assistant. February 2010/Volume 20 Issue 2 and again April 2010 CPT ASsistanVolume 20 Issue 4 that talks about Integumentary vs Musculoskeletal. That might help you, I know that I refer to both alot.
M. Klaubauf, CPC