ED Coding and Reimbursement Alert

Question: A patient reports to the ED with a swollen bump on her left arm. Notes indicate that the physician performed an incision and drainage (I&D) on the wound, sent the patient home, and instructed her to follow up with her primary care physician in five to seven days. Can I report a separate E/M in this scenario? Minnesota Subscriber Answer: If the chart contains only the information in your question, then you should not code a separate E/M. On the claim, report 10060 (Incision and drainage of abscess [e.g. carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia]; simple or single) with 682.3 (Other cellulitis and abscess; upper arm and forearm) appended to represent the patients wound. Your physician likely provided a separate E/M for this patient prior to the I&D; given the nature of EDs, an E/M service is almost a given before a patient receives [...]