tloeb
Networker
I have just acquired coding for a Gender Care clinic at my health system. The provider performs the an exicision of vaginal granulation tissue often long after the global post op period. Would code 58999 be used comparing to 11420-11426 codes or 57100/57105 when performed with scissors and curette? 3 separate examples are below:
1-I first performed a speculum exam and noted extensive exophytic granulation tissue throughout the vaginal cavity, including the apex. I used a combination of scisssor and curette to excise the granulation tissue to its base. Once this was achieved, I used the bovie to control any small areas of bleeding and applied bacitracin ointment to the lining and left a vaginal pack in place until the end of the case to control any oozing. This was removed prior to the end of the case. **58999 compared to 11420 as no measurement or 57105?
2-Speculum exam - there were several areas of granulation tissue that I excised with scissors and curette. Otherwise, lining was healing well without any other abnormalities. The granulation tissue has improved compared to last exam in Jan 2023. **My thought is 58999 compared to 11420 as no measurement or 57105?
3-"There is an area of granulation tissue at the introitus. After confirming allergies, I injected 3 mls 2 % lidocaine into the tissue. I then sharply excised the granulation tissue down to its based and then held pressure with some dry gauze." **My thought is 11420 seems to be the better code selection for this one as the location is the introitus.?
Also, would the better DX code be N99.2 or N76.89 or L92.8.
1-I first performed a speculum exam and noted extensive exophytic granulation tissue throughout the vaginal cavity, including the apex. I used a combination of scisssor and curette to excise the granulation tissue to its base. Once this was achieved, I used the bovie to control any small areas of bleeding and applied bacitracin ointment to the lining and left a vaginal pack in place until the end of the case to control any oozing. This was removed prior to the end of the case. **58999 compared to 11420 as no measurement or 57105?
2-Speculum exam - there were several areas of granulation tissue that I excised with scissors and curette. Otherwise, lining was healing well without any other abnormalities. The granulation tissue has improved compared to last exam in Jan 2023. **My thought is 58999 compared to 11420 as no measurement or 57105?
3-"There is an area of granulation tissue at the introitus. After confirming allergies, I injected 3 mls 2 % lidocaine into the tissue. I then sharply excised the granulation tissue down to its based and then held pressure with some dry gauze." **My thought is 11420 seems to be the better code selection for this one as the location is the introitus.?
Also, would the better DX code be N99.2 or N76.89 or L92.8.