How To Use CPT Code 27323

CPT 27323 describes the procedure of biopsy for superficial soft tissue in the thigh or knee area. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 27323?

CPT 27323 is used to describe the biopsy procedure for superficial soft tissue in the thigh or knee area. It involves the removal of a sample of suspicious tissue for further analysis in a laboratory to determine its nature.

2. Official Description

The official description of CPT code 27323 is: ‘Biopsy, soft tissue of thigh or knee area; superficial.’

3. Procedure

1. The provider prepares the patient and administers anesthesia to the area.
2. An incision is made over the suspicious area in the thigh or knee.
3. The provider excises the superficial soft tissue sample.
4. The excised tissue is sent to a laboratory for analysis.
5. The area is irrigated and the incision is closed.

4. Qualifying circumstances

CPT 27323 is performed when there is a need to remove a sample of superficial soft tissue from the thigh or knee for further analysis. It is typically done when there are suspicions of abnormal tissue or a specific condition that requires evaluation.

5. When to use CPT code 27323

CPT code 27323 should be used when a biopsy of superficial soft tissue in the thigh or knee area is performed. It is important to ensure that the biopsy is superficial and not deep. If the biopsy involves deep tissues, CPT code 27324 should be used instead.

6. Documentation requirements

To support a claim for CPT 27323, the following documentation is required:

• Indication for the biopsy and the need for further analysis
• Details of the procedure, including the specific area of the thigh or knee
• Documentation of anesthesia administration
• Description of the excised tissue and its submission to the laboratory
• Documentation of irrigation and closure of the incision

7. Billing guidelines

When billing for CPT 27323, ensure that the biopsy is performed on superficial soft tissue in the thigh or knee area. It is important to follow the specific documentation requirements and guidelines provided by the payer. Additionally, it is essential to review any bundling or unbundling rules that may apply to ensure accurate billing.

8. Historical information

CPT 27323 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A dermatologist performing a superficial soft tissue biopsy on a suspicious lesion in the thigh area.
2. An orthopedic surgeon conducting a biopsy on superficial soft tissue in the knee area to evaluate a suspected tumor.
3. A plastic surgeon performing a biopsy on superficial soft tissue in the thigh area to assess a suspected lipoma.
4. An oncologist conducting a biopsy on superficial soft tissue in the knee area to determine the presence of metastatic cancer.
5. An orthopedic specialist performing a superficial soft tissue biopsy in the thigh area to evaluate a suspected infection.
6. A rheumatologist conducting a biopsy on superficial soft tissue in the knee area to assess inflammation in a patient with suspected arthritis.
7. A sports medicine physician performing a superficial soft tissue biopsy in the thigh area to evaluate a suspected muscle tear.
8. An interventional radiologist conducting a biopsy on superficial soft tissue in the knee area to assess a suspected vascular abnormality.
9. An orthopedic surgeon performing a superficial soft tissue biopsy in the thigh area to evaluate a suspected cyst.
10. A podiatrist conducting a biopsy on superficial soft tissue in the knee area to assess a suspected nerve entrapment.