How To Use cpt 11772

cpt 11772 describes the excision of a pilonidal cyst or sinus that is complicated and requires extensive dissection. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of cpt 11772.

1. What is cpt 11772?

cpt 11772 is a code used to describe the excision of a pilonidal cyst or sinus that is complicated and requires extensive dissection. This procedure is performed by a healthcare provider to remove the cyst or sinus along with any infected tissue. It is important to note that this code is specifically for complicated cases, such as those with multiple subcutaneous roots or severe infection.

2. Official Description

The official description of cpt 11772 is: ‘Excision of pilonidal cyst or sinus complicated.’

3. Procedure

The procedure for cpt 11772 involves several steps:

1. The patient is prepped and local anesthesia is administered.
2. The healthcare provider makes an incision with a scalpel over the infected area of skin, down to the subcutaneous level.
3. The pilonidal cyst is identified and the limits of the pilonidal cavity are determined using vital dye.
4. The provider drains the pus and removes hair from the area.
5. The entire cyst is excised down to the sacral fascia, along with the surrounding margin.
6. Extensive dissection and debridement of infected tissue may be required.
7. The wound is closed in layers, and skin grafts may be necessary for defects resulting from the excision.
8. The wound may be closed around a drain and may or may not be flushed with antibiotic solution.
9. A dressing is applied to the wound.

4. Qualifying circumstances

cpt 11772 is used for complicated pilonidal cysts that require extensive dissection. This includes cases with multiple subcutaneous roots, recurrence, or severe infection. The documentation should clearly indicate the presence of these qualifying circumstances to support the use of this code.

5. When to use cpt code 11772

cpt 11772 should be used when performing the excision of a complicated pilonidal cyst or sinus that requires extensive dissection. It is important to ensure that the documentation supports the presence of qualifying circumstances, such as multiple subcutaneous roots or severe infection, to justify the use of this code.

6. Documentation requirements

To support a claim for cpt 11772, the healthcare provider must document the following information:

• Patient’s diagnosis and the presence of qualifying circumstances
• Description of the procedure performed, including the extent of dissection and debridement
• Details of any skin grafts or other additional procedures performed
• Date of the procedure
• Start and end time of the procedure
• Any complications or unexpected findings
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for cpt 11772, ensure that the procedure meets the criteria for a complicated pilonidal cyst or sinus excision. It is important to document the presence of qualifying circumstances to support the use of this code. Additionally, be aware of the specific documentation requirements outlined by the payer to ensure accurate billing and reimbursement.

8. Historical information

cpt 11772 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Similar codes to cpt 11772

There are several similar codes to cpt 11772 that may be used in different circumstances:

• cpt 11770: This code is used for the simple excision of a pilonidal cyst.
• cpt 11771: This code is used for the extensive excision of a pilonidal cyst without complications.
• cpt 10080: This code is used for the simple incision and drainage of a pilonidal cyst.
• cpt 10081: This code is used for the complicated incision and drainage of a pilonidal cyst.

9. Examples

1. A patient presents with a recurrent pilonidal cyst that is causing severe pain and infection. The healthcare provider performs an extensive excision of the cyst, including dissection and debridement of infected tissue.
2. A patient with a complicated pilonidal sinus requires surgical intervention. The healthcare provider performs an excision of the sinus, ensuring complete removal of the affected tissue.
3. A patient with a pilonidal cyst presents with multiple subcutaneous roots. The healthcare provider performs an excision of the cyst, carefully removing all roots to prevent recurrence.
4. A patient with a severe pilonidal cyst infection undergoes an extensive excision procedure. The healthcare provider performs debridement of infected tissue and closes the wound with skin grafts.
5. A patient with a complicated pilonidal cyst requires surgical intervention due to recurrent infections. The healthcare provider performs an excision of the cyst, ensuring complete removal of all infected tissue.