How To Use CPT Code 27634

CPT 27634 describes the excision of a tumor in the soft tissue of the leg or ankle area, specifically beneath the fascia or within the muscle. 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 27634?

CPT 27634 is used to describe the excision of a tumor in the soft tissue of the leg or ankle area. The tumor is located beneath the fascia or within the muscle and measures 5 cm or greater in diameter. This code is used when the provider removes the tumor without removing a significant amount of surrounding normal tissue.

2. Official Description

The official description of CPT code 27634 is: ‘Excision, tumor, soft tissue of leg or ankle area, subfascial (eg, intramuscular); 5 cm or greater.’

3. Procedure

1. The provider begins by preparing and anesthetizing the patient.
2. An incision is made in the skin over the tumor in the leg or ankle area.
3. The incision is deepened through the subcutaneous tissue and fascia.
4. The provider removes the tumor from within the fascia or muscle, along with narrow margins of normal tissue surrounding the lesion.
5. Any bleeding is controlled, and the incision is closed in layers.

4. Qualifying circumstances

CPT 27634 is used for the excision of tumors in the soft tissue of the leg or ankle area that measure 5 cm or greater in diameter. The procedure is performed without removing a significant amount of surrounding normal tissue. The tumors can be either benign or cancerous.

5. When to use CPT code 27634

CPT code 27634 should be used when the provider performs an excision of a tumor in the soft tissue of the leg or ankle area that measures 5 cm or greater in diameter. It is important to note that this code should not be used for tumors with a diameter less than 5 cm, as a different code (CPT 27619) should be used in those cases.

6. Documentation requirements

To support a claim for CPT 27634, the provider must document the following information:

• Patient’s diagnosis and the need for tumor excision
• Size of the tumor
• Location of the tumor (leg or ankle area)
• Details of the procedure, including the incision, removal of the tumor, and closure
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 27634, ensure that the excision is performed in the soft tissue of the leg or ankle area and that the tumor measures 5 cm or greater in diameter. This code should not be reported with codes for complex closure, neuroplasty, or adjacent tissue transfer. It is important to check with insurers regarding the use of a surgical assistant during the procedure, as some may require the use of modifier 80 or AS.

8. Historical information

CPT 27634 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 provider performs an excision of a 7 cm tumor in the soft tissue of the leg for a patient with a benign lesion.
2. A surgeon removes a 6 cm tumor from the muscle of the ankle area for a patient with a cancerous growth.
3. A provider excises a 5.5 cm tumor beneath the fascia of the leg for a patient with a benign mass.
4. A surgeon performs an excision of a 9 cm tumor within the muscle of the ankle area for a patient with a cancerous tumor.
5. A provider removes an 8 cm tumor from the soft tissue of the leg for a patient with a benign lesion.
6. A surgeon excises a 6.5 cm tumor beneath the fascia of the ankle area for a patient with a cancerous growth.
7. A provider performs an excision of a 5 cm tumor within the muscle of the leg for a patient with a benign mass.
8. A surgeon removes a 7.5 cm tumor from the soft tissue of the ankle area for a patient with a cancerous tumor.
9. A provider excises a 6.2 cm tumor beneath the fascia of the leg for a patient with a benign lesion.
10. A surgeon performs an excision of an 8.7 cm tumor within the muscle of the ankle area for a patient with a cancerous growth.