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Multiple Mohs procedures making one defect

When my Mohs surgeon has side by side skin cancers and are all being treated with Mohs as separate lesions, when the procedure is done it has created one defect site. If you are treating that wound site with for example with skin substitute used for healing,can you measure the entire site as one defect? Almost impossible to differentiate each individual defect since the margins were so close they overlapped.

Shardel

Medical Billing and Coding Forum

Triceps Defect Repair

I have a provider that performed an Arthrotomy on the elbow along with repairing a triceps defect. The provider has coded 24342, but I don’t see that an actual reinsertion was performed. Op note reads: "An incision was then outlined in marker over the olecranon draining sinus, which actively drained purulent material.* The skin was incised sharply with an ellipse made around sinus. and then tenotomy scissors were used for further dissection. The deep portion of sinus tract was sent for culture. Aerobic an anaerobic cultures were taken.* The surrounding tissue was debrided with combination of curette and rongeur.* We noted a longitudinal defect within the midline of the triceps. Patient had XR imaging which hinted at previous injury but did not complain of weakness. Given the possibility that there was communication with olecranon fossa, the defect was carried down to olecranon fossa and arthrotomy was made. Once the area was adequately debrided, Betadyne and then Gentamicin-Saline mixture was used to thoroughly irrigated the area.* Any remaining necrotic tissue was debrided and more irrigation used.

The triceps defect was closed with 0 Vicryl. The subcutaneous tissue was then closed with 2-0 monocryl and skin closed with staples. Xeroform, 4×4’s, webril was used to dress wound. A anterior elbow splint was applied"

I have 24101 for the arthrotomy. I’m having a problem finding a code for the repair. Should I maybe use an unlisted code?

Thanks

Medical Billing and Coding Forum