Dermatology Coding Alert

Published on Tue Mar 06, 2012 PDF

Question: A patient presents to the office with cysts all over her body. The dermatologist cut into the cysts, removing 20 while draining each cyst. What is the appropriate code for this procedure?

North Dakota Subscriber

Answer: Report it by using 10061 (Incision and drainage of abscess [e.g., carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia], complicated or multiple) with modifier 22 (Increased procedural services).

Reminder: To support modifier 22, you should send all necessary documentation to the insurance. The CPT® manual specifies that "documentation must support the substantial additional work and the reason for the additional work (i.e., increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required)."

In a similar manner, selecting the appropriate I&D (incision and drainage) code means the documentation will have to support the complexity of the procedure. You can support a complicated I&D when the procedure requires multiple incisions or the abscess gets complicated by an infection.