Wiki Lipoma removals

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cnramsey

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Just came back from our coders meeting and this procedure note was discussed. Does the provider need to state ie subcutaneous to bill from the Musculoskeletal section? Or are all lipomas to be coded in the Musculoskeletal section no matter what?
PREOPERATIVE DIAGNOSES:
1. Bilateral thigh lipoma with two on the right thigh and one on the left thigh.
2. Right back lipoma.
3. Left flank lipoma.
POSTOPERATIVE DIAGNOSES:
1. Left thighs 3 x 2 cm lipoma removed through a 3 cm incision.
2. Right thigh superior lipoma measuring 1 x 1 cm removed through a 2 cm incision.
3. Right thigh lateral inferior lymphoma measuring 2 x 1 cm removed through a 2 cm incision.
4. Right back 3 x 2 cm lipoma removed through a 3 cm incision.
5. Left back 2 x 1 cm lipoma removed through a 3 cm incision.
PROCEDURE PERFORMED: Excision of five lipomas with the above measurements.
 
The best reference I have found on this topic is from the AMA in their CPT Assist publication from August 2006. The AMA was asked about the best code to report excision of a lipoma from the flank. In their response, they state lipomas are most often in superficial tissues such as skin and subcutaneous tissue but may also be in deeper tissues such as subfascial or muscular layers. They indicated in this article that the excision of a lipoma could be coded to benign lesion codes from the integumentary system (11400-11446) when the lipoma was present in superficial tissues or you could code from the musculoskeletal section if the lipoma was in deeper tissues such as the deep subcutaneous, fascia, or muscle layers.

Based on that response, I typically require physicians to tell me the depth of the lipoma in terms of cutaneous, subcutaneous, fascia, or muscle layers since it is possible to code from either the integumentary or musculoskeletal sections of CPT for excision of a lipoma.

I hope that helps - have a great night!

Kim
www.codingmastery.com
 
cpc2007 said:
The best reference I have found on this topic is from the AMA in their CPT Assist publication from August 2006. The AMA was asked about the best code to report excision of a lipoma from the flank. In their response, they state lipomas are most often in superficial tissues such as skin and subcutaneous tissue but may also be in deeper tissues such as subfascial or muscular layers. They indicated in this article that the excision of a lipoma could be coded to benign lesion codes from the integumentary system (11400-11446) when the lipoma was present in superficial tissues or you could code from the musculoskeletal section if the lipoma was in deeper tissues such as the deep subcutaneous, fascia, or muscle layers.

Based on that response, I typically require physicians to tell me the depth of the lipoma in terms of cutaneous, subcutaneous, fascia, or muscle layers since it is possible to code from either the integumentary or musculoskeletal sections of CPT for excision of a lipoma.

I hope that helps - have a great night!

Kim
www.codingmastery.com
Click to expand...
Kim,

Thank you so much for getting back to me. This is exactly what I was needing to know!!

Nichole
 
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