Wiki Gynecology skin coding

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Is excision and biopsy of vulvar skin tag with biopsy coded 56605 biopsy of vulva or perineum, 11200 removal of skin tag(s) up to 15, 11422 excision benign lesion incl biopsy? 11102 Tangential (scissor biopsy) points to 56605 for vulv/perineum. It has been my understanding that unless specifically listed in Integumentary section, due to the sensitivity and complexity involved in the genital area, coding is to be found in the Genital 50000 series, rather than the Integumentary 10000 series.

SAMPLE REPORT EXCERPT:

...... Patient found to have a vulvar lesions . The abnormal area is located on the right side of the labia minora. Its appearance is 1.5cm skin tag.

The patient was placed on the table in a dorsal lithotomy position. The area was prepped with Zephrin . The area was injected with 0.5 cc's of 1% Lidocaine with epinephrine. After adequate anesthesia was reached, the skin tag was grasped and removed with scissors at the base.

The specimen was placed in formalin and sent to pathology for evaluation. Pressure was applied to the biopsy site to control bleeding and sutures were not needed to close the wound. Hemostasis was achieved with the use of silver nitrate.
 
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Skin tag...
First, because it is mentioned several times in the note, and second, because of the manner in which it was removed ("scissors"). An excision (11422) needs to define the depth of the lesion into dermis and margins etc and "excludes skin tags". A biopsy procedure (11102) is defined as removing thin slices of a lesion using a blade.
 
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