Cartilage CPT Guidance Excision — CPT Coding Question
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Alicia: This particular one pushed me out of my comfort zones because it was mostly a CPT question, and as our regulars knows, Laureen is the CPT Queen, I like ICD. This was a question that I think our person was trying to get answered for a while.

Q:“I could really use some input on this surgery. Is the excision of the cartilage included in the excision of the BCCA of the helical rim? Any CPT guidance would be greatly appreciated. Thank you!”

A: Ultimately, without reading the entire scenario, or entire case, this patient hada basal cell carcinoma on the right, and this is the ear. What they did was they did an excision of the basal cell carcinoma and then did a local tissue rearrangement. It was called an Antia-Buch advancement flap, it’s 10 sq cm, which is very important you need to know the size when you have anything like this going on, as well as, for your CPT, you need to know the size,you need to know what body part it’s being done on and that is a rearrangement. The whole fact that it says Antia-Buch, that’s not pertinent to your code for this scenario.

Ultimately, without looking at all the fodder about what was done to this patient, they had a place on their ear that needed to be removed. So, they went in, they removed it, and then they have to repair the hole that was left from the removal. It states when you do read it that there were two pieces sent off to pathology to make sure that it was clean.

Basal cell carcinoma is something that you don’t want to mess around with because it just grows and grows and grows and grows. And if it’s not taken care of when they do remove it, it can be huge.

So, this is where she gets a little confused or gets concerned, is that they go in and they do this procedure and then it says, this was taken through the cartilage as well – meaning, they cut into the cartilage. They had to go back to pathology twice, he tells us what type of a repair, and then again, “I performed elevation of the cartilage. The cartilage was then advanced and anchored with a 4-0 Monocryl” which is just the type of suture thread that they’re using.

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