Wiki Removal of incisional endometrioma

[cgarciamck87@gmail.com]

Patient came in due to pain lateral to a previous csection incision. After doing a fine needle aspiration in office, it was determined that it showed endometriosis in the incision. Provider is asking to see what code would be used for the removal of the incisional endometrioma. At firs, I thought it would be 49203, but now I am not too sure about this.

 

[Cmama12]

49203 is for peritoneal, mesenteric, or retroperitoneal locations. Depending on how deep it is you could consider

Reader Question:

Code This Wound Exploration, Fascia Endometrioma Removal​

Published on Mon Jun 13, 2016

PDF
Question: I need help locating the right CPT® code.

Procedure: old incision was incised on the left using a scalpel and carried down through the subcutaneous tissue. Wound was explored and scar tissue removed. What appeared to be an abdominal lipoma was removed with Bovie cautery. Mass felt in fascia opened with scalpel. Old blood was under fascia so thickened area removed and old blood cleaned out.

Path Report: endometriosis; polarizable foreign material associated multinucleated giant cell response and fat necrosis.

North Carolina Subscriber

Answer: Have you looked at codes 22902 (Excision, tumor, soft tissue of abdominal wall, subcutaneous; less than 3 cm) and 22903 (… 3 cm or greater)? These seem to be in keeping with the work involved, but you will have to know the size of the lipoma. Cleaning up the scar tissue would be included.

 

[cgarciamck87@gmail.com]

49203 is for peritoneal, mesenteric, or retroperitoneal locations. Depending on how deep it is you could consider

Reader Question:

Code This Wound Exploration, Fascia Endometrioma Removal​

Published on Mon Jun 13, 2016

PDF
Question: I need help locating the right CPT® code.

Procedure: old incision was incised on the left using a scalpel and carried down through the subcutaneous tissue. Wound was explored and scar tissue removed. What appeared to be an abdominal lipoma was removed with Bovie cautery. Mass felt in fascia opened with scalpel. Old blood was under fascia so thickened area removed and old blood cleaned out.

Path Report: endometriosis; polarizable foreign material associated multinucleated giant cell response and fat necrosis.

North Carolina Subscriber

Answer: Have you looked at codes 22902 (Excision, tumor, soft tissue of abdominal wall, subcutaneous; less than 3 cm) and 22903 (… 3 cm or greater)? These seem to be in keeping with the work involved, but you will have to know the size of the lipoma. Cleaning up the scar tissue would be included.

Thank you!