General surgery CPT changes 2010: Keep the Skin in Integumentary
If you think every large lesion that extends deeper than the dermis is a soft tissue tumor
, think again. Do not make an upcoding error that could land your practice in a soup. Here are some tips to ensure that you distinguish new CPT 2010 musculoskeletal soft tissue tumor codes from procedures better described by integumentary entries.
Take a clue from cancer source
Soft tissue tumor excision codes and skin cancer treatment codes are not interchangeable based on size or even depth of excision. With uncommon exceptions, you should use integumentary codes for skin cancers and save the new 20000 series soft tissue codes for lesions that don't arise in the dermis.
Origin is important: The use the new excision codes, the tumor should stem from the musculoskeletal system, extend through the white fat subcutaneous layer and not be a tumor that originates in the skin.
You should follow text note: To see to it that you do not misuse the new CPT codes, CPT provides this instruction in the revised musculoskeletal system introduction. For radical resection of tumors of cutaneous origin, see 11600-+11646.
Allow cancer type to guide you
If your surgeon removes a malignant melanoma that extends into the muscle, should you make use of the new soft tissue tumor resection codes? Almost never. Even if the tumor is deep, majority of the time you should choose from the integumentary codes for a melanoma excision.