AHA Coding Clinic® for HCPCS - 2020 Issue 4; Ask the Editor

Umbilicoplasty

A patient with a history of gastroschisis with silo repair subsequently developed periumbilical swelling and tenderness which appeared to be a hernia. A decision was made to perform a hernia repair. An incision was made with dissection through the dermis. The skin was raised under a skin tag in the lower left corner of the umbilicus. Underneath the skin tag was herniated fat. The 0.5 cm herniated fat defect was excised noting the underlying fascia was intact. Rather than a hernia, it was discovered that there was periumbilical scar tissue. The surrounding scar tissue was lysed and the inner margin of the initial incision was excised incorporating the skin tag. How is this umbilicoplasty coded? Is the unlisted integumentary CPT code 17999, correct when the dissection goes below the skin level? ...

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