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Tip: Lipoma removals

Ambulatory Surgery Reimbursement Update, June 3, 2008

Lipomas are benign fatty tumors that can occur in the surface, subcutaneous or deeper tissues. They arise in soft tissue areas and can occur on the chest, back, flank, neck, shoulder, arm, hand, wrist, fingers, hip, pelvis, leg, ankle, or foot.

Lipomas can be of varying depth into the tissues. They can be superficial, in surface or subcutaneous tissues, or extend deep into the intramuscular tissues.

While lipomas have diagnosis codes (located in the 214.X section of the ICD-9-CM Manual), there are no CPT procedure codes that specifically state they are for the excision of a lipoma. Instead you would need to code for the excision of a lesion or tumor.

It is very important to code these procedures accurately by using the appropriate code from the 2008 CPT Manual. Use a code from the 10000 section (11400-11446) if the lipoma is very surface and located in the epidermis or dermis (e.g., code 11401 for the excision of a lipoma from the arm just under the skin surface that is 0.7 cm in size). Code from the 20000-section codes if the physician removes the lipoma from a deep intramuscular tissue area (e.g., code 24076-RT for the excision of a lipoma from deep intramuscular tissue of the right upper arm). When reporting a 10000-section integumentary code, you need to know the exact size of the excised lesion.

This tip is brought to you by Ellis Medical Consulting, Inc.

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