How To Use CPT Code 22900

CPT 22900 describes the excision of a soft tissue tumor from the abdominal wall, specifically from the subfascial layer, that is less than 5 cm in size. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 22900?

CPT 22900 is used to describe the excision of a soft tissue tumor from the abdominal wall, specifically from the subfascial layer, that is less than 5 cm in size. The procedure involves making an incision through the skin and subcutaneous tissue over the lesion, raising subcutaneous flaps with electrocautery, excising the tumor from the muscle layer, and submitting the specimen for laboratory analysis.

2. Official Description

The official description of CPT code 22900 is: ‘Excision, tumor, soft tissue of abdominal wall, subfascial (eg, intramuscular) less than 5 cm.’

3. Procedure

During the procedure for CPT 22900, the patient is appropriately prepped and anesthetized. The provider makes an incision through the skin and subcutaneous tissue over the lesion and raises subcutaneous flaps with electrocautery. The tumor is then excised from the muscle layer, ensuring complete removal. The excised specimen is submitted to a laboratory for analysis to determine its nature. The provider then irrigates the area, checks for bleeding, removes any instruments, and closes the incision.

4. Qualifying circumstances

CPT 22900 is used for the excision of a soft tissue tumor from the abdominal wall, specifically from the subfascial layer. The tumor must be less than 5 cm in size. The procedure is typically performed when the tumor is causing symptoms or is suspected to be malignant. The patient must meet the necessary preoperative requirements and be appropriately prepped and anesthetized for the procedure.

5. When to use CPT code 22900

CPT code 22900 should be used when a provider performs the excision of a soft tissue tumor from the abdominal wall, specifically from the subfascial layer, that is less than 5 cm in size. It is important to ensure that the tumor meets the size criteria and that the procedure is medically necessary.

6. Documentation requirements

To support a claim for CPT 22900, the provider must document the following information:

• Patient’s diagnosis and the need for tumor excision
• Size and location of the tumor
• Details of the procedure, including the incision, excision, and closure
• Submission of the excised specimen for laboratory analysis
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 22900, ensure that the excision is performed on a soft tissue tumor of the abdominal wall, specifically from the subfascial layer, that is less than 5 cm in size. It is important to follow the appropriate coding guidelines and ensure accurate documentation to support the claim. CPT code 22900 should not be reported with other excision codes for the same tumor. It is also important to review any specific billing guidelines from payers to ensure compliance.

8. Historical information

CPT 22900 was added to the Current Procedural Terminology system on January 1, 1990. On January 1, 2010, the code description was changed to specify ‘abdominal wall tumor’ instead of ‘tumor’ to provide more clarity.

9. Similar codes to CPT 22900

There are several similar codes to CPT 22900 that describe excision procedures on the abdomen. These include:

• CPT 22901: Excision, tumor, soft tissue of abdominal wall, subfascial (eg, intramuscular), 5 cm or greater
• CPT 22902: Excision, tumor, soft tissue of abdominal wall, subfascial (eg, intramuscular), greater than 5 cm
• CPT 22903: Excision, tumor, soft tissue of abdominal wall, subfascial (eg, intramuscular), less than 3 cm
• CPT 22904: Excision, tumor, soft tissue of abdominal wall, subfascial (eg, intramuscular), 3 cm or greater
• CPT 22905: Excision, tumor, soft tissue of abdominal wall, subfascial (eg, intramuscular), greater than 3 cm

9. Examples

1. A provider performs the excision of a 4 cm soft tissue tumor from the subfascial layer of the abdominal wall.
2. A patient undergoes the excision of a 2 cm soft tissue tumor from the intramuscular layer of the abdominal wall.
3. A provider performs the excision of a 6 cm soft tissue tumor from the subfascial layer of the abdominal wall.
4. A patient undergoes the excision of a 3 cm soft tissue tumor from the intramuscular layer of the abdominal wall.
5. A provider performs the excision of a 5 cm soft tissue tumor from the subfascial layer of the abdominal wall.
6. A patient undergoes the excision of a 1 cm soft tissue tumor from the intramuscular layer of the abdominal wall.
7. A provider performs the excision of a 4 cm soft tissue tumor from the subfascial layer of the abdominal wall.
8. A patient undergoes the excision of a 2 cm soft tissue tumor from the intramuscular layer of the abdominal wall.
9. A provider performs the excision of a 6 cm soft tissue tumor from the subfascial layer of the abdominal wall.
10. A patient undergoes the excision of a 3 cm soft tissue tumor from the intramuscular layer of the abdominal wall.