Here's What You Should When You Code For Lipoma

By Author: Nancy Rose
Total Articles: 53
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There's no denying that it gets a bit more than tricky when you code for lipoma. Occurring commonly under the skin, lipomas are actually non-cancerous tumors made entirely of fat cells. Knowing the definition of lipoma will make your work a lot easier - because you'll know the growth's location in the body very easily. Under the skin means lipomas are not found in the skin, but in subcutaneous layer or tissue.


Look for the code for lipoma in the musculoskeletal section of the CPT. General surgery coders usually go for the integumentary section - because their perception is that the musculoskeletal does not apply to them, but only to orthopedics! In the descriptions for excisions in the musculoskeletal section, size is usually not the factor; rather, the depth of the removed tumor is the factor.


Beginning with the 20000-series of codes, the musculoskeletal section is subcategorized according to the parts of the body. It begins with the head, then the neck, back, ...
... spine, and shoulder. More or less, there's an excision category in every section - further subcategorized into subcutaneous, deep and radical. These are the three different kinds of tumor removals, and that's exactly where the coders should look.


There are times when your carrier will request an operative report for verification of the different sites. The carriers also insist that general surgeons should not write off second and third procedures automatically. The reason is quite simple. When you submit the op note and underline each separate procedure on each area of a particular body-part, you'll get reimbursement for all three procedures. You have to make sure that the medical necessity of the procedure in the initial visit is documented by the physician. This will make sure your code for lipoma is specific.


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