Wiki Guyon's canal exploration cpt code??

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ahodge90

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I have a surgery that I am stumped on, and was hoping someone could help me figure this one out.
my doc was planning on removing a mass but after getting closer to the "mass" he realized it was a thrombosed artery. He did not remove anything after finding this out. He just closed the incision. He is calling it a Wrist mass exploration After reading the note, it sounds like a Guyon's canal exploration. I am not finding anything that comes closed to this, so I am thinking this should be an unlisted wrist code??? I cannot get the op note to upload. Sorry! Anyone have any advice on this??
 
Definitely an interesting scenario. You could consider 35702 (exploration of an artery of the upper extremity not followed by surgical repair) given the final diagnosis of thrombosis of the artery. That would accurately represent what ultimately occurred. The alternate would be an unlisted as you suggested because all mass excision codes in that area of anatomy require more specific diagnoses such as a ganglion cyst, and the "mass" was ultimately thrombosis of the artery. So even if you tried to use a mass excision code with a modifier 52 since no excision was performed, you would get a denial due to your final diagnosis of thrombosed artery. I like the 35702 here but would consider the unlisted as backup if you need it (e.g., surgeon gets a denial for reporting this code with his specialty since he is not a vascular surgeon).

I hope that helps :)

Kim
www.codingmastery.com
 
cpc2007 said:
Definitely an interesting scenario. You could consider 35702 (exploration of an artery of the upper extremity not followed by surgical repair) given the final diagnosis of thrombosis of the artery. That would accurately represent what ultimately occurred. The alternate would be an unlisted as you suggested because all mass excision codes in that area of anatomy require more specific diagnoses such as a ganglion cyst, and the "mass" was ultimately thrombosis of the artery. So even if you tried to use a mass excision code with a modifier 52 since no excision was performed, you would get a denial due to your final diagnosis of thrombosed artery. I like the 35702 here but would consider the unlisted as backup if you need it (e.g., surgeon gets a denial for reporting this code with his specialty since he is not a vascular surgeon).

I hope that helps :)

Kim
www.codingmastery.com
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thank you for your imput on this! I appreciate it!
 
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