How To Use CPT Code 23071

CPT code 23071 describes the excision of a tumor or abnormal mass from the soft tissues of the shoulder area, specifically the subcutaneous tissue, that is 3 cm or greater 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 23071?

CPT 23071 is used to describe the excision of a tumor or abnormal mass from the soft tissues of the shoulder area. This procedure specifically targets the subcutaneous tissue and is performed when the mass is 3 cm or larger in size. The excised tissue is then sent to a laboratory for analysis and diagnosis.

2. Official Description

The official description of CPT code 23071 is: ‘Excision, tumor, soft tissue of shoulder area, subcutaneous 3 cm or greater.’

3. Procedure

During the procedure for CPT 23071, the patient is appropriately prepped and anesthetized. The healthcare provider makes an incision over the mass in the shoulder area and uses microdissection techniques to carefully remove the tumor or abnormal mass. A margin of surrounding tissue is also excised to ensure complete removal. The excised tissue is then sent to a laboratory for analysis and diagnosis. The provider irrigates the wound area and closes the incision with sutures.

4. Qualifying circumstances

CPT 23071 is performed on patients who have an abnormal mass or tumor in the soft tissues of the shoulder area. The mass must be located in the subcutaneous tissue and be 3 cm or larger in size. This code is specifically for the excision of tumors or abnormal masses and should not be used for the excision of benign lesions of cutaneous origin, such as sebaceous cysts.

5. When to use CPT code 23071

CPT code 23071 should be used when a healthcare provider performs the excision of a tumor or abnormal mass from the soft tissues of the shoulder area, specifically the subcutaneous tissue. This code is applicable when the size of the mass is 3 cm or greater. It is important to note that this code should not be used for the excision of benign lesions of cutaneous origin.

6. Documentation requirements

To support a claim for CPT 23071, the healthcare provider must document the following information:

• Patient’s diagnosis and the presence of an abnormal mass or tumor
• Size of the mass or tumor, confirming it is 3 cm or greater
• Description of the excision procedure, including the use of microdissection
• Margin of surrounding tissue excised
• Documentation of specimen submission for analysis and diagnosis
• Details of wound irrigation and closure

7. Billing guidelines

When billing for CPT 23071, ensure that the excised mass or tumor meets the size requirement of 3 cm or greater. It is important to accurately document the procedure and submit the excised tissue for analysis. CPT code 23071 should not be reported for the excision of benign lesions of cutaneous origin. It is also important to follow any specific guidelines provided by the payer regarding the use of this code.

8. Historical information

CPT code 23071 was added to the Current Procedural Terminology system on January 1, 2010. There have been no updates or changes to the code since its addition.

9. Similar codes to CPT 23071

There are several similar codes to CPT 23071 that describe excision procedures on the shoulder area. These include:

• CPT 23065: Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); less than 3 cm
• CPT 23066: Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); 3 cm or greater
• CPT 23075: Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); 5 cm or greater
• CPT 23220: Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); 5 cm or greater
• CPT 23221: Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); 5 cm or greater

9. Examples

1. A healthcare provider performs the excision of a 4 cm tumor from the subcutaneous tissue of a patient’s shoulder.
2. An abnormal mass measuring 5 cm is excised from the soft tissues of a patient’s shoulder area.
3. A tumor measuring 3.5 cm is removed from the subcutaneous tissue of a patient’s shoulder.
4. The healthcare provider performs the excision of a 6 cm tumor from the soft tissues of a patient’s shoulder area.
5. An abnormal mass measuring 4.5 cm is excised from the subcutaneous tissue of a patient’s shoulder.
6. A tumor measuring 3.2 cm is removed from the soft tissues of a patient’s shoulder area.
7. The healthcare provider performs the excision of a 5.5 cm tumor from the subcutaneous tissue of a patient’s shoulder.
8. An abnormal mass measuring 3.8 cm is excised from the soft tissues of a patient’s shoulder area.
9. A tumor measuring 4.7 cm is removed from the subcutaneous tissue of a patient’s shoulder.
10. The healthcare provider performs the excision of a 3.3 cm tumor from the soft tissues of a patient’s shoulder area.