Help! I am at a loss. My Doc (Dermatologist) performed an excision of a neurofibroma, lesion + margins is 1.7 X 1.6cm. She also performed an ED of 6 adjacent NF. We originally billed the claim as 11442 and 17110. However, according to our Medicare LCD (We're in Alabama) neither 237.XX or 215.XX are acceptable diagnoses for the procedures! I have spent an hour scouring the internet on advice as to how to code this but I am coming up with nothing. I am wondering if we are using the wrong codes? Any help is much appreciated!!!
re: coding excision and ED of multiple Neurofibromas
Pathology reads "A dermal mass with fairly circumscribed margins and both the cytologic and architecttural features of schwannian differentiation is present. An S-100 immunostain strongly highlights the lesional cells confirming a neural origin. A CD31 immunostain highlights scattered small vessels but fails to highlight the lesional cells themselves." Under Diagnosis summary it just reads "A- Center of forehead - Neurofibroma".
Under the alphabetic index of my ICD-9 book when I look up neurofibroma it says "see also, Neoplasm, connective tissue, benign" and multiple neurofibroma points to 237.70. This was excised from the forehead, so neoplasm, connective tissue, benign, forehead is 215.0.
ED stands for electrodessication. My bad! I get caught up in abbreviations sometimes. Thanks so much for your help!!!