Adjacent tissue transfer, trunk, 8 sq.cm. Give the appropriate code.

An 57-year-old man, status post ventral hernia repair, has incision and drainage of an infected postoperative abscess in the doctor’s office. The wound is closed after placement of a latex drain. The patient is placed on p.o. antibiotics. The culture grows staph aureus. Give the appropriate CPT code.

Mr. Philips met with an accident. He presented to his primary care doctor. The doctor has to do complex repair of a 5.5 cm cut on his left flank and intermediate repair of a 20 cm cut on his left hand. What CPT codes the doctor should bill for?

The frozen section pathology after 1.5 cm malignant melanoma lesion showed positive margins, so an additional excision for 2.5 cm was done in the post operative period of the initial procedure. How will you code the second re-excision procedure?

A patient presents to the dermatologist with a suspicious lesion on her left arm and on her right arm. After examination the physician feels these lesions present as highly suspicious and obtains consent to perform punch biopsies on both sites. After prepping the area, the physician injects the sites with Lidocaine 1 percent and 0.05 percent Epi. A 3 mm punch biopsy of the lesion of the left arm and a 4 mm punch biopsy of the lesion of the right arm is taken. The sites are closed with a simple one layer closure and the patient is to return in 10 days for suture removal and to discuss the pathology results. The patient tolerated the procedure well. Select the CPT code(s) for this procedure.

Patient presents with a cyst on the arm. Upon examination the physician decides to incise and drain the cyst. The site is prepped and the physician takes a scalpel and cuts into the cyst. Purulent fluid is extracted from the cyst and a sample of the fluid is sent to the laboratory for evaluation. The wound is irrigated with normal saline and covered with a bandage. The patient is to return in a week to ten days to re-examine the wound. Select the CPT code for this procedure.

A patient presents to the primary care physician with multiple skin tags. After a complete examination of the skin the provider discusses with the patient the removal of 18 skin tags located on the patient’s neck and shoulder area. Patient consent is obtained and the provider removes all 18 skin tags by scissoring technique. Select the CPT codes for this procedure.

A patient presents for tattooing of the nipple and areola of both breasts after undergoing breast reconstruction. The total area of the right breast is 11.5 sq.cm and for the left breast of 10.5 sq.cm. Select the CPT codes for this procedure.

A patient presents to the dermatologist with a suspicious lesion of the left cheek. Upon examination the physician discusses with the patient the best course of treatment is to remove the lesion by shave technique. Consent is obtained and the physician preps the area and using an 11-blade-scalpel, makes a transverse incision and slices the lesion at the base. The wound is cleaned and a bandage is placed, the physician indicates the size of the lesion is 1.4 cm. The lesion is sent to pathology for evaluation and the patient is to return in 10 days to discuss the findings. Select the CPC codes for this procedure.

A patient presents to her doctor with three medium sized suspicious lesions on her leg. The physician uses a saw type instrument and slices horizontally to remove the lesions. The lesions are sent for pathology. What CPT code(s) should be reported for this example?

A patient presents to the emergency department with multiple lacerations. After inspection and cleaning of the multiple wounds the physician proceeds to close the wounds. The documentation indicates the following: 2.7 cm complex closure to the right upper abdominal area, a 1.4 cm complex repair to the right buttock, a 7.4 cm intermediate repair to the right arm, a 3.8 cm intermediate repair to the left cheek, a 8.1 cm intermediate repair to the scalp, and a 2.3 cm simple repair of the right lower lip. What are the correct CPT codes to report for this example?

Operative Report: Indications for Surgery: The patient has a dysplastic nevus on the right upper abdomen. The area is marked for elliptical excision with gross normal margins of 4 to 6 mm in relaxed skin tension lines of the respective are and the best guess at the resulting scars is drawn. The patient observed these marks in a mirror to understand the surgery and agrees on the location and we proceeded. Procedure: The area was infiltrated with local anesthetic. The area is prepped and draped in sterile fashion. The dysplastic nevus right upper abdomen lesion measuring 2.2 cm with margins is excised as drawn, into the subcutaneous fat. Suture is used to mark the specimen at its medial tip, and labelled 12 o’ clock. This is sent for permanent pathology. Meticulous homeostasis is achieved using light pressure. The patient tolerated the procedure well. What is the correct CPT code to report for this example?

Operative Report: Indications for Surgery: The patient has a dysplastic nevus on the right upper abdomen. The area is marked for elliptical excision with gross normal margins of 4 to 6 mm in relaxed skin tension lines of the respective are and the best guess at the resulting scars is drawn. The patient observed these marks in a mirror to understand the surgery and agrees on the location and we proceeded. Procedure: The area was infiltrated with local anesthetic. The area is prepped and draped in sterile fashion. The dysplastic nevus right upper abdomen lesion measuring 2.2 cm with margins is excised as drawn, into the subcutaneous fat. Suture is used to mark the specimen at its medial tip, and labelled 12 o’ clock. This is sent for permanent pathology. Meticulous homeostasis is achieved using light pressure. The patient tolerated the procedure well. What is the correct CPT code to report for this example?

Operative Report: Indications for Surgery: The patient is a 72-year-old male with a biopsy-proven squamous cell carcinoma of his left forearm. With his permission, I marked my planned excision and my best guess at the resultant scar, which included a rhomboid flap repair. The patient observed these markings in a mirror, so he could understand the surgery and agree on the location; I proceeded. Description of Procedure: The patient was given 1 g of IV Ancef. The area was infiltrated with local anesthetic. The forearm was prepped and draped in a sterile fashion. I excised this lesion measuring 1.2 cm diameter as drawn into the subcutaneous fat. A suture was used to mark this specimen at its proximal tip and this was labelled at 12 o’clock. Negative margins were then given. Meticulous hemostasis was achieved using a Bovie cautery. I incised my planned rhomboid flap measuring 2 cm x 2 cm. I elevated the flap with a full-thickness of skin and subcutaneous fat. The total defect size was 5.44 sq.cm. The flap was rotated into the defect and the donor site was closed and the flap was inset in layers using 4-0 Monocryl and 5-0 Prolene. Loupe magnification was used throughout the procedure and the patient located the procedure well. What CPT code(s) should be reported for this example?

Patient presents to the dermatolosist for the removal of warts on his hands. Upon evaluation it is noted the patient has nine warts on his right hand and 10 on his left hand, all of which he has indicated he would like removed today. After discussion with the patient regarding the destruction method and aftercare the patient agree to proceed. Using cryosurgery the physician applied two squirts of liquid nitrogen on each of the warts on his right and left hand. Aftercare instructions were given to the patient’s wife. The patient tolerated the procedure well. What CPT code(s) should be reported for this example?

Patient returns to the dermatologist after biopsies were done on several lesions. In discussing the pathology results with the patient , the physician indicated she had a superficial basal cell carcinoma (BCC) on her right cheek and left hand. The physician discussed the different treatment options with the patient and she decided to try cryosurgery to destroy the skin cancers. Informed consent was obtained. The physician noted the measurements of the BCC of the face to be 0.7 cm and the BCC on the left hand to be 1.2 cm prior to destruction. What are the correct CPT codes to report for this example?

A patient has a squamous cell carcinoma on the tip of the nose. After prepping the patient and site, the physician removes the tumor (first stage) and divides it into seven blocks for examination. Seeing positive margins, he removes a second stage, which he divides into five blocks. The physician again identifies positive margins. He performs a third stage and divides specimen into three blocks proving to be clear of the skin cancer? What are the correct CPT codes to report for this example?

A patient present for reduction of her left breast due to atrophy of the breast. After being prepped and draped, the surgeon makes a circular incision above the nipple to indicate where the nipple is to be relocated. Another incision is made around the nipple, and then two more incision are made from the circular cut above the nipple to fold beneath the breast, which creates a keyhole shaped skin and breast incision. Skin wedges and tissue are removed until the surgeon is satisfied with the size. Electrocautery was performed on bleeding vessels and the nipple was elevated to its new position and the nipple pedicle was sutured with layered closure. The last incision was repaired with a layered closure as well. What is the correct CPT code to report for this example?

A 32-year-old female is having excision of a mass in her left breast. The physician makes a curved incision along the inferior and medial aspect of the left areola. A breast nodule measuring approximately 1 cm in diameter, was identified. It appeared to be benign. It was firm, gray, and discrete. It was completely excised. There were no gross evidence of malignancy. The bleeding was controlled with electrocautery. The skin edges were approximated with a continuous subcuticular 4-0 Vicryl suture. Indermil tissue adhesive was applied to the skin as well as a dry gauze dressing. What is the correct CPT code to report for this example?

53-year-old male for removal of 2 lesions located on his nose and lower lip. Lesions were identified and marked. Utilizing a 3-mm punch, a biopsy was taken of the left supratip nasal area. The lower lip lesion of 4mm in size was shaved to the level of the superficial dermis. What are the codes for these procedures?

An 8-year old child sustains two percent total body surface area third degree burns from boiling water she accidentally spills on her hands. The wounds are open and draining. She is taken to the operating room for surgical excision of the burn wounds to prepare the recipient site and simultaneous application of a dermal autograft. Code the procedure.

A patient presented to the operating room for a modified radical mastectomy, including axillary lymph nodes, and saline prosthesis insertion on the right breast, due to primary breast cancer. Apply all the correct CPT and ICD-9-CM codes.

Forty-two days after an abdominal aortic aneurysm repair, a 72 year old patient returns to see his vascular surgeon with the complaint of six fibrocutaneous tags on his neck. The provider takes a brief history, performs a problem focused exam of the lesion area and determines electrosurgery of the tags would be the best approach. The provider performs electrosurgical destruction of the skin tags. What are the appropriate CPT and ICD-9-CM codes?

A patient has six wounds repaired. Three wounds 2 cm of the scalp, 3.5 cm on the leg and 1.5 cm on the face require simple repairs. Two more wounds 1 cm on the foot and 3 cm on the hand require layered closures. The final procedure is a complex repair 5 cm on the ear. Code these repairs and list them according to complexity.

Code the surgical preparation of a 70 sq cm hypertrophic burn scar of the arm and the split thickness graft required to cover the defect created.

A physician removes 17 fibrocutaneous tags by electrosurgical destruction. Code the services performed to destroy these lesions.

Code the excision of a benign lesion located on the face having a diameter including margins of 2.5 cm and one neck lesion with 0.75 cm, including margins

Excision of malignant skin lesions was being performed. The first lesion was located on the trunk and measured 2.1 cm. The second lesion was located on the face and measured 3.0 cm. A third lesion was located in the scalp and measured 3.5 cm. the measurements are based on diameter and include margins. Code these services and diagnoses.

During a riot on the street in front of a federal building, an 18-year old female is hit in the face and left foot with flying glass and sustains a complicated wound (4 cm in length) to the right cheek that requires a complex repair. She requests a plastic surgeon (Surgeon A) repair the wound to her cheek while a general surgeon (surgeon B) repairs a wound on her left foot (7.7 cm) with a layered closure. Code both surgeon’s procedures and diagnoses.

Patient presents with a vertical 4 cm scar on the lateral border of her right elbow. The patient complains that the scar contraction limits their range of flexion and wishes to have it removed and corrected surgically. The surgical site is prepped with Betadine and sterile drapes are applied. Two arms are drawn at each end of the linear scar, inscribing an angle of 60 degrees to the scar. The side arms are exactly equal in length to the central scar and have precisely the same angle. Local anesthesia is administered. The physician then makes two vertical incisions through the skin along the lines, using a no.15 scalpel blade and excises the vertical scar tissue. Full thickness skin flaps are undermined at the level of subcutaneous fat, creating two triangular flaps of equal size and shape (Z-plasty) for 10sq cm. Adequate undermining of surrounding subcutaneous tissue is performed to achieve proper mobilization of the flaps. The two flaps are then transposed around each other changing the direction of the original scar. The flaps are held n place internally with a few anchoring stitches. The skin is closed using interrupted sutures. Topical antibiotics and a pressure dressing are applied and the patient is told to return in two weeks fro suture removal. What is the correct code(s)?

A 45-year old was shooting hoops with his neighbors in the drive way. He lost his balance and hit his head on a wool retaining wall along the driveway. He presents to the emergency room with a 8 cm laceration of his forehead. On examination the laceration involves only the subcutaneous tissues. The wound id quite dirty with what appears to be mud and cut grass. After copious washing small splinters of wood can be seen and are removed before the wound is closed with one layer closure. What is the correct code?

A patient requires extensive skin grafts following burns of the lower left leg. The physician harvests skin for the graft. Late she applies the STSG graft to a 200 square cm area.

A patient presents with flash burns for the entire face, second degree, 25 percent of the neck, second degree and the left forearm and hand, third degree. The dermatologist debrides the face and neck and then performs an escharotomy using 2 incisions to the left forearm and hand, all under general anesthesia. Code the treatment.

DIAGNOSIS: Lesion of the left mandibular line times two. HISTORY: This patient has two lesion on her left jaw line with "dog-ears" on either end, and she desires revision of these areas for more normal anatomic reconstruction site. She, therefore, presents today for definitive removal of these lesions. PROCEDURE: With the patient in the supine position under intravenous sedation, 1% lidocaine with 1:100,000 epinephrine buffered with sodium bicarbonate was injected into the two lesions in question along the left jaw line. Each lesion measured approximately 1.5 cm in length. Having waited 10 minutes for vasoconstriction to occur, each lesion was excised under loupe magnification with a #15 Bard-Parker. Hemostasis was obtained with the Bovie. The closure was performed with two layers of 5-0 Vicryl, followed by running, fine, 6-0 black nylon, again under loupe magnification. The patient tolerated the procedure well. Sponge and needle counts were reported as correct.

Code the CPT and ICD-9 Procedural Codes for the Op Report Below DIAGNOSIS: Macromastia. ANESTHESIA: General OPERATION: McKissock reduction mammoplasty, inferior pedicle only. PROCEDURE: Under adequate general anesthesia, the breasts were prepped and draped in a routine fashion and injected with 0.5% Xylocaine with 1:200,000 epinephrine to aid in hemostasis. The patient's breasts had been marked for standard McKissock reduction mammoplasty preoperatively with the patient in the sitting position. The right breast was operated upon first, and a standard McKissock reduction mammoplasty was carried out, creating medial and lateral flaps and excising medial and lateral triangles. The nipple was supported with an inferior pedicle approximately 10 cm. in width. Good viability of the nipple was present at the termination of dissection. Approximately 1,000 grams of breast tissue was removed from the left breast, and 1,000 grams from the right breast. The patient's wounds were closed with clear and black nylon fine sutures. Sterile dressings were applied, and the patient returned to the recovery room in satisfactory condition with a bra in place. Both breasts were operated upon in equal fashion. No drains were placed. There were no complications.

Bobbie "bumpy" Fimple decides to quit the circus and have 151 skin tags removed. How is this reported?

This patient returns today for palliative care to her feet. Her toenails have become elongated and thickened, and she is unable to trim them on her own. She states that she has had no problems and no acute signs of any infection or otherwise to her feet. She returns today strictly for nail debridement to her feet. EXAMINATION: Her pedal pulses are palpable bilaterally. The nails are mycotic, 1 through 4 on the left, and 1 through 3 on the right. ASSESSMENT: Onychomycosis, 1 through 4 on the left and 1 through 3 on the right. follow-up palliative care.

Preoperative Diagnosis: Right breast mass Postoperative Diagnosis: Same Operation: Right subcutaneous mastectomy Indications for Surgery: Operative findings included benign-appearing breast tissue. Frozen section reports as benign breast tissue consistent with gynecomastia. The patient is a 51-year-old male who presented to the clinic complaining of swelling in his right breast under his nipple and areola. He complained that this area was tender and was concerned about possible cancer. The patient was scheduled for outpatient procedure, breast biopsy versus subcutaneous mastectomy. Procedure: After obtaining signed consent, the patient was taken to the operating room and placed in comfortable supine position. After placing all proper anesthesia monitoring devices, EKG, blood pressure and saturation monitors, the patient's right breast was prepped and draped in the usual sterile fashion. Once this was completed, 1% lidocaine was used to infiltrate the inferior aspect circumareolarly and a #15 blade was then used to make an incision circumareolar from 3 o'clock and 6 o'clock to 9 o'clock on the nipple and small extending incisions were created laterally and medially at 3 o'clock and 5 o'clock. This incision was carried down through the skin and into the subcutaneous tissue. Skin flaps were then created using Metzenbaum scissors. Allis clamps were used to secure the mass and the mass was dissected out using electrocautery Bovie. After excision the mass, the lateral border of the mass was marked with long silk, the superior aspect of the mass was marked with a short stitch. This was then passed off to pathology for frozen section. Inspecting the wound, the wound was dry. It was irrigated copiously with normal saline. A 3-0 Vicryl was used to reapproximate the subcutaneous tissue to obliterate the dead space and a 4-0 Vicryl suture was used to reapproximate the skin edges using a subcuticular stitch. Steri-strips were then applied over the wound. A sterile dressing was placed over the wound. The patient tolerated the procedure well and there were no complications. A total of 7 cc of 1% lidocaine were used during the case. The estimated blood loss was less than 10 cc. There were no drains.

A male patient presents for bilateral mastectomy with a diagnosis of gynecomastia. Choose the correct procedure and diagnosis codes.

A woman is referred to a plastic surgeon when excessive skin weighs down her eyelids to the point that her sight is impaired. The surgeon performs bilateral blepharoplasty 2 weeks later. Which of the following would be correct for the surgical procedure?

Operative Report: Excision lesion on right shoulder, 2.5 x 1.0 x .5 cm. The 3 cm defect was closed in layers. Excision, skin of left cheek, 1.0 x 1.0 x .5. 1.5 cm laceration was closed primarily. Pathology report states that the skin lesion on the right shoulder is a lipoma and the lesion on the left cheek is a squamous cell carcinoma.

Choose the code that describes cryotherapy for acne

A 32-year-old male skidded out of control on a wet road while riding his motorcycle. He sustained an open fracture of the shaft of the tibia. The wound was grossly contaminated with road debris. The wound was debrided down to the level of the exposed bone (no bone was debrided) to remove the foreign material on the first day. A planned additional debridement was performed on the third day, which did include some bone, and planned open reduction was performed on the fourth day (a plate and screws were used). Select the codes for the services on all three days.

James suffered a severe crushing injury to his left upper leg. Two days after surgery, Dr. Barnes completed a dressing change under general anesthesia. How would you report this service?

Dr. Jess removed a 4.5 cm (excised diameter) cystic lesion from Amy’s forehead. The ulcerated lesion was anesthetized with 20 mg of 1% Lidocaine and then elliptically excised. The wound was closed with a layered suture technique and a sterile dressing applied. The wound closure, according to Dr. Jess’s documentation, was 5.3 cm. How would you report this procedure?

Martha has a non-healing wound on the tip of her nose. After an evaluation by Dr. Martino, a dermatologist, Martha is scheduled for a procedure the following week. Dr. Martino documented an autologous split thickness skin graft to the tip of Martha’s nose. A simple debridement of granulated tissues is completed prior to the placement. Using a dermatome, a split thickness skin graft was harvested from the left thigh. The graft is placed onto the nose defect and secured with sutures. The donor site is examined, which confirms good hemostasis. How would you report this procedure?

76-year-old female had a recent mammographic and ultrasound abnormality in the 6 o’clock position of the left breast. She underwent core biopsies which showed the presence of a papilloma. The plan now is for needle localization with excisional biopsy to rule out occult malignancy. After undergoing preoperative needle localization with hookwire needle injection with methylene blue, the patient was brought to the operating room and was placed on the operating room table in the supine position where she underwent laryngeal mask airway (LMA) anesthesia. The left breast was prepped and draped in a sterile fashion. A radial incision was then made in the 6 o'clock position of the left breast corresponding to the tip of the needle localizing wire. Using blunt and sharp dissection, we performed a generous excisional biopsy around the needle localizing wire including all of the methylene blue-stained tissues. The specimen was then submitted for radiologic confirmation followed by permanent section pathology. Once hemostasis was assured, digital palpation of the depths of the wound field failed to reveal any other palpable abnormalities. At this point, the wound was closed in 2 layers with 3-0 Vicryl and 5-0 Monocryl. Steri-Strips were applied. Local anesthetic was infiltrated for postoperative analgesia. What CPT and ICD-9-CM codes describe this procedure?

A patient had a chest wall tumor excised. The procedure involved the ribs with plastic reconstruction, and mediastinal lymphadenectomy. How would you report this procedure?

Dr. Alexis completed Mohs surgery on Ralph’s left arm. She reported routine stains on all slides, mapping, and color coding of specimens. The procedure was accomplished in three stages with a total of seven blocks in the second stage. How would you report Dr. Alexis’ services?

Tina fell from a step ladder while clearing drain gutters at her home. She suffered contusions and multiple lacerations. At the emergency room she received sutures for lacerations to her arm, hand, and foot. The doctor completed the following repairs: superficial repair to the arm of 12.8 cm, a single-layered closure of 7.9 cm that required extensive cleaning and removal of glass from the hand, and a simple repair to the foot of 9.6 cm How would you report the wound repairs?

James had a malignant lesion removed from his right arm (excised diameter 4.6 cm). During the same visit the dermatologist noticed a new growth on James’ left arm. Dr. Terry took a biopsy of the new lesion and sent it in for pathology. The biopsy site required a simple closure. How would Dr. Terry report the the procedures?

Indication: Patient has a hypertrophic scar on the posterior side of the left leg at the level of the knee. This has begun to restrict his mobility. Physical therapy trial was unsuccessful. Procedure: After the proper induction of anesthesia, the subcutaneous tissue of the patient’s left leg beneath the scar was infiltrated with crystalloid solution containing epinephrine to minimize blood loss. The scar was then excised down to viable dermis. Hemostasis was obtained with epinephrine soaked pads. Skin was harvested from the patient’s thigh in a split thickness fashion and was used to cover the 90 sq cm defect created by the surgery. The graft was secured with skin staples and then dressed with fine mesh gauze followed by medication-soaked gauze. The donor site was dressed with mesh followed by Adaptic, followed by a dry dressing and an Ace wrap.

The physician is called in to perform repairs for a 17-year-old girl involved in a motor vehicle accident. She sustained an 8.6 cm laceration to her forehead, a 5.5 cm laceration to her right cheek, a 4 cm laceration to her left cheek, a 4 cm laceration across her chin, and a 12.5 cm laceration to her chest. The wound on her chin required a layered closure. All other wounds required complex closure.

A 36-year-old male presents to have multiple lesions destroyed. Three benign lesions on his face are destroyed and five actinic keratoses on his left arm are destroyed. Code for the procedures.

46 year old female had a previous biopsy that indicated positive margins anteriorly on the right side of her neck. A 0.5 cm margin was drawn out and a 15 blade scalpel was used for full excision of an 8cm lesion. Light undermining of all margins was performed along with layered closure. The specimen was sent for permanent histopathologic examination. What are the code(s) for this procedure?

30 year old female is having debridement performed on an infected ulcer with eschar on the right foot. Using sharp dissection, the ulcer and eschar infection was debrided all the way to down to the bone of the foot. The bone had to be minimally trimmed because of a sharp point at the end of the metatarsal. After debriding the area, there was minimal bleeding because of very poor circulation of the foot. It seems that the toes next to the ulcer may have some involvement and cultures were taken. The area was dressed with sterile saline and dressings and then wrapped. What CPT code should be reported?

PRE OP DIAGNOSIS: Left Breast Abnormal MMX or Palpable Mass; Other Disorders Of Breast PROCEDURE: Automated Stereotactic Biopsy Left Breast FINDINGS: Lesion is located in the lateral region, just at or below the level of the nipple on the 90 degree lateral view. There is a subglandular implant in place. I discussed the procedure with the patient today including risks, benefits and alternatives. Specifically discussed was the fact that the implant would be displaced out of the way during this biopsy procedure. Possibility of injury to the implant was discussed with the patient. Patient has signed the consent form and wishes to proceed with the biopsy. The patient was placed prone on the stereotactic table; the left breast was then imaged from the inferior approach. The lesion of interest is in the anterior portion of the breast away from the implant which was displaced back toward the chest wall. After imaging was obtained and stereotactic guidance used to target coordinates for the biopsy, the left breast was prepped with Betadine. 1% lidocaine was injected subcutaneously for local anesthetic. Additional lidocaine with epinephrine was then injected through the indwelling needle. The SenoRx needle was then placed into the area of interest. Under stereotactic guidance we obtained 9 core biopsy samples using vacuum and cutting technique. The specimen radiograph confirmed representative sample of calcification was removed. The tissue marking clip was deployed into the biopsy cavity successfully. This was confirmed by final stereotactic digital image and confirmed by post core biopsy mammogram left breast. The clip is visualized projecting over the lateral anterior left breast in satisfactory position. No obvious calcium is visible on the final post core biopsy image in the area of interest. The patient tolerated the procedure well. There were no apparent complications. The biopsy site was dressed with Steri-Strips, bandage and ice pack in the usual manner. The patient did receive written and verbal post-biopsy instructions. The patient left our department in good condition. IMPRESSION: 1. SUCCESSFUL STEREOTACTIC CORE BIOPSY OF LEFT BREAST CALCIFICATIONS. 2. SUCCESSFUL DEPLOYMENT OF THE TISSUE MARKING CLIP INTO THE BIOPSY CAVITY 3. PATIENT LEFT OUR DEPARTMENT IN GOOD CONDITION TODAY WITH POST-BIOPSY INSTRUCTIONS. 4. PATHOLOGY REPORT IS PENDING; AN ADDENDUM WILL BE ISSUED AFTER WE RECEIVE THE PATHOLOGY REPORT. What are the codes for the procedures?

53-year-old male for removal of 2 lesions located on his nose and lower lip. Lesions were identified and marked. Utilizing a 3-mm punch, a biopsy was taken of the left supratip nasal area. The lower lip lesion of 4mm in size was shaved to the level of the superficial dermis. What are the codes for these procedures?

76-year-old has dermatochalasis on bilateral upper eyelids. A blepharoplasty will be performed on the eyelids. A lower incision line was marked at approximately 5 mm above the lid margin along the crease. Then using a pinch test with forceps the amount of skin to be resected was determined and marked. An elliptical incision was performed on the left eyelid and the skin was excised. In a similar fashion the same procedure was performed on the right eye. The wounds were closed with sutures. The correct CPT codes are?

Patient has basal cell carcinoma on his upper back. A map was prepared to correspond to the area of skin where the excisions of the tumor will be performed using Mohs micrographic surgery technique. There were three tissue blocks that were prepared for cryostat, sectioned, and removed in the first stage. Then a second stage had six tissue blocks which were also cut and stained for microscopic examination. The entire base and margins of the excised pieces of tissue were examined by the surgeon. No tumor was identified after the final stage of the microscopically controlled surgery. What procedure codes should be reported?000

45 year old male is in outpatient surgery to excise a basal cell carcinoma of the right nose and have reconstruction with an advancement flap. The 1.2 cm lesion with an excised diameter of 1.5 cm was excised with a 15-blade scalpel down to the level of the subcutaneous tissue, totaling a primary defect of 1.8 cm. Electrocautery was used for hemostasis. An adjacent tissue transfer of 3 sq cm was taken from the nasolabial fold and was advanced into the primary defect. Which CPT code(s) should be used?

24 year old patient had an abscess by her vulva which burst. She has developed a soft tissue infection caused by gas gangrene. The area was debrided of necrotic infected tissue. All of the pus was removed and irrigation was performed with a liter of saline until clear and clean. The infected area was completely drained and the wound was packed gently with sterile saline moistened gauze and pads were placed on top of this. The correct CPT code is:

Debridement of the skin of the abdominal wall due to necrotizing soft tissue infection, the wound was closed with insertion of mesh.

Following excision of a malignant lesion of the nose, the subsequent pathology report shows that an additional excision is necessary to remove the entire lesion. The patient is schedules for a second visit during the postoperative period of the primary excision and the remainder of the lesion is removed. The original lesion measures 1.2 cm with skin margins of 0.6 cm. the second encounter involved excising an additional area having a diameter of 1.2 cm along one of the original margins. Select the CPT code for the second encounter.

Hair transplant, 21 punch grafts. Give the appropriate CPT code.

Surgical treatment of burn with escharotomy, 4%, 11-year-old female. Give the appropriate CPT code.

A squamous cell carcinoma (diameter 0.8 cm) of the right palm was excised with margins. The remaining defect measured 0.8 cm by 0.9 cm and was repaired by using split skin graft reconstruction. Give the appropriate CPT code.