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Posted By angie on 11-13-2019, 15:15:16 in Ob-Gyn

CPT code ??

Indications:The patient is a 52 year old Caucasian/White female who was recently diagnosed by excisional biopsy of molluscum contagiosum. After the diagnosis was confirmed by removing 2 separate lesions, the patient has now elected to return for surgical excision of the remaining largest molluscum lesions. She has several molluscum lesions scattered on the perineum and mons pubis that she would like removed. I discussed the pros, cons, risks, benefits and potential complications. The patient expressed understanding and wishes to have these lesions excised. Since she has had 2 similar lesions removed within the last two weeks and both were confirmed to be molluscum contagiosum, the lesions are removed today will not be submitted for gross and microscopic examination. The patient is in agreement with this plan of care. After being presented with the risks, benefits and specific details of the procedure, informed consent was obtained and signed
Procedure:The patient was placed on the table in a dorsal lithotomy position and draped in the appropriate manner. The area was prepped with betadine . The areaa of the molluscum lesions were prepped with Betadine solution. Each lesion was injected with 1 cc's of 1% Lidocaine without epinephrine, using a 27 gauge needle. After adequate anesthesia was reached, Each molluscum lesion was excised using the tip of an iris scissors to unroofed the inner core remove the entire lesion. There were 8 molluscum lesions that were removed, scattered on the mons pubis, perineum and labia.
Since the diagnosis of molluscum contagiosum had already been made on previous biopsies ,the 8 lesions that were removed were not sent for gross or microscopic examination. The patient was in agreement with this plan of care. Three of the lesions were bleeding after removal and a Band-Aid was applied. Hemostasis was adequate.
The patient tolerated the procedure well. There were no complications.



Figure 1.0: Perineum
8 molluscum lesions as diagrammed were excised/removed from the mons pubis, labia, and perineum. The patient tolerated the procedure well, particularly after injecting each sidewith 1% lidocaine. There were no complications.
Comments (1)
Posted By Melanie Witt on 11-13-2019, 16:11:10
This is not a true surgical excision which would include the lesion plus margins so the 11xxx codes would not be correct (and you don't have lesion size either). This looks more like surgical curettement so I would go with 17110 which is up to 14 lesions. Or you could possibly consider 56501 even thought surgical curettement is not mentioned (the code includes examples, not a complete list of destruction methods.).
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