ED Coding and Reimbursement Alert
I&D Area Can Deflate 10060 Option
Question: The ED physician performs a level-four E/M service for a patient and diagnoses a peritonsillar abscess. Notes indicate that the physician aspirates the abscess to confirm the presence of pus, and then incises and drains it. Is this a 10060 incision and drainage (I&D)? Minnesota Subscriber Answer: These types of abscesses have their own I&D codes. For this encounter you would report the following codes: 42700 (Incision and drainage abscess; peritonsillar) for the I&D 99284 (Emergency department visit for the evaluation and management of a patient, which requiresthese 3 key components: detailed history; a detailed examination; and medical decision making of moderate complexity ...) for the E/M modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) appended to 99284 to show that the E/M and aspiration were separate services 475 (Peritonsillar abscess) appended to 42700 and 99284 to represent the patient's abscess. As you can see from the 42700 descriptor, it is a more accurate code choice than 10060 (Incision and drainage of abscess [e.g., carbuncle, supprative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia; simple or single]) for this particular I&D. Reader Questions and You Be the Coder reviewed by Michael A. Granovsky, MD, CPC, FACEP, president of MRSI, an ED coding and billing company in Woburn, Mass.
ED Coding and Reimbursement Alert
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I&D Area Can Deflate 10060 Option
Question:The ED physician performs a level-four E/M service for a patient and diagnoses a peritonsillar [...]
