SCENARIO: Baylie Cole is a 27-year-old female, diagnosed with a soft tissue benign tumor on the large toe, no prior pain or illness.Ms. Cole had a procedure in order to remove a soft tissue benign tumor from her toe. Anesthesia was not needed, localized numbing of the area sufficed. The tumor was removed by a single surgeon and biopsied.Everything went according to plan and she was released the same day.
THE CODES USED WOULD BE:
CPT Code: 28108-T5 Excision or curettage of bone cyst or benign tumor, phalanges of foot, right foot, great toe (Abraham)
HCPCS Code: G8883 Biopsy results reviewed, communicated, tracked and documented (“hcpcs codes”)
HCPCS Code: G8508 Documentation of pain assessment (including location, intensity and description) (“hcpcs codes”).
EXPLANATIONS FOR CODES USED: This CPT code is correct because it involves the removal of tumors on the toe. The HCPC codes explain what was done before and after the procedure. In this case the doctor determined that the tumor caused her little or no pain and most likely would access the level of pain experienced during the procedure, the numbing agent was mean to assist in managing pain. After the procedure a biopsy on the removed tissue was performed to ensure that the tumor was indeed benign.
Medical codes are essential in insuring that everything that took place during the procedure is properly documented and so that billing and determine what charges apply for that particular patient (Buck). The also help both the patient and other doctors understand what procedure took place and what they were charged for. A uniformed coding system insures that all medical facilities can recognize a procedure by a uniform code. It is not open to the interpretation of the doctor, but instead guidelines put forward medical organizations.
Works Cited:
Abraham, Michelle. CPT 2011: current procedural terminology. Standard ed. Chicago, Ill.: American Medical Association, 2010. Print.
Buck, Carol J.. Step-by-step medical coding. 2005 ed. St. Louis, Mo.: Saunders, 2005. Print.
"HCPCS Codes." icd data. N.p., n.d. Web. 2 May 2013.
