Resection of Pelvic Masses - Medical Coding скачать в хорошем качестве

Resection of Pelvic Masses - Medical Coding

Handouts, transcripts, enhanced video replay and instructor access are available to CCO Club members. If you are interested in membership visit http://cco.us/club. Resection of a pelvic mass. The question came in and I thought this was a fantastic question: Q: AMA created CPT code 49203 thru 49205 for resection of pelvic masses. (Some of you who are newer, the AMA puts out the CPT code, procedure codes for outpatient coding procedures.) Are these codes supposed to be coded when the primary organ have been removed? For example, 30 cm large pelvic mass turned out to be cystoadenoma of the ovary excised separately and then performed hysterectomy. A: Ultimately, what’s going on here is that I just went ahead and pulled out from Find-A-Code that first code 49203 and let’s look at that since we have so many new people, that’s an excision or destruction. That means we’re taking out or destroying. Open – meaning they’re going to go in and open them up, not doing it laparoscopically. Intra-abdominal tumors, cysts, or endometriomas, 1 or more peritoneal, mesenteric or retroperitoneal primary or secondary tumors; largest tumor 5 cm diameter or less. For our newbies which really warms my heart because I’m sure when I said all of that, you were impressed with my knowledge and you thought, “Wow! That’s intimidating” and you want to grow up to be a coder just like me so you can say those big words. The fact is, we’re just taking something out; we’re taking a tumor or a cyst out. This code 49203 is a code range going up to 49205 and the fact is, is we are not going to code for that excision or destruction of the tumor or cyst if the actual whole organ is taking out. Because it’s actually two different procedures, you’re either going to do an ablation and destroy that. Here is a great graphic, as some of you may know I like to do pictures, so that is actually a laparoscopic view of the uterus and all those little things that are wrapped around it, look to me not as an expert, probably adhesions and stuff, so they’re going to go in and remove that. When you look at that code range, the 49203 - 49205 is based on the size of the tumor, the diameter of the tumor that they’re going to take out. But if we’re taking out the entire uterus and most of the time when they do that, they end up doing a hystero oophorectomy which means that they’re taking the uterus and the ovaries. Or, this is a word I learned back when I was very young and just starting out in the medical field, hysterosalpingoophorectomy. If you need the verbiage that just means you’re taking the uterus, the fallopian tubes, and the ovaries; we’re taking everything out and I got the codes for that at the end here, we’ll look at it. Find-A-Code is brilliant because it gives you a description of what is happening when you have these procedure codes. So just quickly, it’s just saying that we’re doing an open excision or destruction of an intra-abdominal or retroperitoneal tumors. So, something is going on in there and we’re going to destroy it. We’re going to get rid of this tissue. A lot of times it’s because it could be benign but it gets bigger and it causes a problem, discomfort. Sometimes things that are benign can turn into cancerous depending on the cells and the pathologist can make that decision, but it doesn’t matter if it’s benign – meaning, noncancerous or if it’s malignant, which is cancerous. They’re still using this code to take that out; where with ICD sometimes you have to define whether it’s benign or malignant. Again, we’re going to go in, we’re going to take out the abnormal tissue but leave the organ. That’s what those codes mean. Our person had asked, if we’re going to go out to take out the tumor, but we’re also taking out the organ itself, do we code for taking out the tumor and the organ, or do we just code the organ? Notice here in the description of that code, it said the tumor could be completely excised or destroyed because sometimes they do like an ablation. That’s important to know. Also, just for your own benefit, know that the location, the size and the extent of the tumor needs to be noted in the documentation for you to be able to pick the code to the highest specificity. Just also for your information as we scroll down, retroperitoneal tumors are treated in the same phase as if we’re working taking care of maybe an injury to the kidneys, the uterus or renal vessels. Then, just showing you again those codes are based on the size.