Wiki Revision of Incision...help!!

[gurtmurt79]

Not quite sure how to code this. Any help would be appreciated.

I coded the excision of neuroma 64782, does that look correct? Im not quite sure how to code the revision of incision. Please help!

Preoperative Diagnosis:
1. Prior carpal tunnel release.
2. Incisional tenderness with nodular tissue along the incision line consistent with a subcutaneous neuroma.
3. Postoperative MRI scan revealing no residual median nerve compression in the carpal tunnel.
Postoperative Diagnosis: Same.

Procedure:
1. Revision of carpal tunnel release incision.
2. Excision of subcutaneous nodule consistent with neuroma

 

[tbuxton]

Because the documentation doesn't state that this IS a neuroma, only that it's a subcutaneous nodule "consistent with" a neuroma, I would not use a neuroma excision code, but would instead use:

25075 Excision, tumor, soft tissue of orearm and/or wrist area, subcutaneous; less than 3 cm

There is no need to code the "incision revision" separately, as it merely describes the approach to the excision.