How To Use CPT Code 27043

CPT 27043 describes the excision of a subcutaneous soft tissue tumor in the pelvis and hip area that is 3 centimeters 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 27043?

CPT 27043 is used to describe the excision of a subcutaneous soft tissue tumor in the pelvis and hip area that is 3 centimeters or larger in size. This code is specifically for tumors located in the subcutaneous layer, which is below the surface of the skin. It is important to note that this code should not be used for the excision of benign lesions of cutaneous origin, such as sebaceous cysts, which have their own specific codes.

2. Official Description

The official description of CPT code 27043 is: ‘Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; 3 cm or greater.’ It is important to refer to this official description when reporting this code to ensure accurate billing.

3. Procedure

1. When performing CPT 27043, the healthcare provider begins by appropriately prepping and anesthetizing the patient.
2. The provider then makes an incision through the skin and subcutaneous tissue over the tumor.
3. Using electrocautery, the provider may raise subcutaneous flaps to expose the tumor.
4. The tumor, along with a margin of normal tissue, is excised by the provider.
5. During the excision, the provider ligates small feeding blood vessels to minimize bleeding.
6. After excision, the provider irrigates the wound to clean it out.
7. The provider then closes the incision by suturing the layers of tissue together.

4. Qualifying circumstances

CPT 27043 is used for the excision of subcutaneous soft tissue tumors in the pelvis and hip area that are 3 centimeters or larger in size. It is important to note that this code should only be used for tumors in the subcutaneous layer and not for tumors in other layers or for benign lesions of cutaneous origin. The provider must ensure that the tumor meets the size criteria and is located in the specified anatomical area before reporting this code.

5. When to use CPT code 27043

CPT code 27043 should be used when a healthcare provider performs the excision of a subcutaneous soft tissue tumor in the pelvis and hip area that is 3 centimeters or larger in size. It is important to accurately document the size of the tumor and its location to support the use of this code. If the tumor is smaller than 3 centimeters, a different code should be used.

6. Documentation requirements

To support a claim for CPT code 27043, the healthcare provider must document the following information:

• The size of the tumor
• The location of the tumor in the pelvis and hip area
• A description of the procedure performed, including the use of electrocautery and the excision of a margin of normal tissue
• Details of any ligated blood vessels
• The method of wound closure

7. Billing guidelines

When billing for CPT code 27043, ensure that the excision is performed on a subcutaneous soft tissue tumor in the pelvis and hip area that is 3 centimeters or larger in size. It is important to accurately document the size and location of the tumor to support the use of this code. Additionally, it is important to note that CPT code 27043 should not be reported if the tumor is smaller than 3 centimeters or if it is a benign lesion of cutaneous origin. It is also important to follow any specific guidelines or requirements set by the payer when reporting this code.

8. Historical information

CPT code 27043 was added to the Current Procedural Terminology system on January 1, 2010. There have been no updates to the code since its addition.

9. Examples

1. A healthcare provider performs the excision of a 4 cm subcutaneous soft tissue tumor in the pelvis and hip area.
2. During a surgical procedure, a provider removes a 5 cm subcutaneous soft tissue tumor in the pelvis and hip area.
3. A patient undergoes the excision of a 3.5 cm subcutaneous soft tissue tumor in the pelvis and hip area.
4. A provider performs the excision of a 6 cm subcutaneous soft tissue tumor in the pelvis and hip area.
5. During a surgical procedure, a healthcare provider removes a 3.2 cm subcutaneous soft tissue tumor in the pelvis and hip area.
6. A patient undergoes the excision of a 4.5 cm subcutaneous soft tissue tumor in the pelvis and hip area.
7. A provider performs the excision of a 3.8 cm subcutaneous soft tissue tumor in the pelvis and hip area.
8. During a surgical procedure, a healthcare provider removes a 5.5 cm subcutaneous soft tissue tumor in the pelvis and hip area.
9. A patient undergoes the excision of a 3.3 cm subcutaneous soft tissue tumor in the pelvis and hip area.
10. A provider performs the excision of a 4.8 cm subcutaneous soft tissue tumor in the pelvis and hip area.