A polyp is a tissue mass shaped like a stalk or finger (like a skin tag) but a cyst is a fluid filled sac under the skin or mucosa. So there is a difference and excision of a cyst or tumor of the vagina would be represented by code 57315 because they have to dig it out of the vaginal wall. A polyp, on the other hand, is usually hanging on the surface and can be cut with scissors. 11420 requires a local anesthesia, and per the CPT knowledgebase "The excision codes (1142X) can be used to remove skin lesions, including a margin, and the lesion is typically deep, but is closed with sutures and is not a layered closure." So in the case, how was the polyp removed? And did the removal match the requirements for 11420?