wound exploration and removal of fascia endometrioma

I need help with a surgical code. It was scheduled as wound exploration and removal of fascia endometrioma.

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 thicked(yes, that's what the OP report says) area removed and old blood cleaned out. Fascia was reapproximated with o-vicryl. Subcutaneous tissue was copiously irrigated with saline and closed with vicryl. Skin was closed in usual subcutaneous fashion and derma bond placed.

Path report states: soft tissue, abdominal wall, excision:

endometriosis

polarizable foreign material associated multinucleated giant cell response and fat necrosis

No malignancy identified

We are looking at the 22900-22903 codes or 49203.

Thank you!!


Cathy Satkus, CPC
Harvard Family Physicians
918-743-8200

Comments

  • edited May 2017
    I think I would stick with the 22900 codes.

    Lori

  • edited May 2017
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    The 22900 series is the way to go as the abdominal cavity was never entered.



    From: Cathy Satkus [mailto:Cathy.Satkus@harvardfamily.com]
    Sent: Tuesday, May 24, 2016 3:44 PM
    To: Multiple recipients of list PARTB-L
    Subject: [partb-l] wound exploration and removal of fascia endometrioma



    I need help with a surgical code. It was scheduled as wound exploration and
    removal of fascia endometrioma.

    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 thicked(yes, that's what the OP report says) area removed and old
    blood cleaned out. Fascia was reapproximated with o-vicryl. Subcutaneous
    tissue was copiously irrigated with saline and closed with vicryl. Skin was
    closed in usual subcutaneous fashion and derma bond placed.

    Path report states: soft tissue, abdominal wall, excision:

    endometriosis

    polarizable foreign material associated
    multinucleated giant cell response and fat necrosis

    No malignancy identified

    We are looking at the 22900-22903 codes or 49203.



    Thank you!!





    Cathy Satkus, CPC

    Harvard Family Physicians

    918-743-8200








  • edited May 2017
    Thank you Jan and Lori!


    Cathy Satkus, CPC
    Harvard Family Physicians
    918-743-8200

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