ED Coding and Reimbursement Alert

Question: What is the difference between a simple and complicated finger abscess drainage?

Texas Subscriber

Answer: The codes for each are different, as are the actions the ED physician will take for each drainage type.

Report simple abscess drainage with 26010 (Drainage of finger abscess; simple). During this procedure, the physician will find the abscess in the superficial subcutaneous tissue of the finger and drain it with a needle. They will also pack the wound with gauze.

Report complicated abscess drainage with 26011 (… complicated (eg, felon)). For a complicated drainage, the physician will first remove any dirt, blood, or other debris. They will then make a lateral incision along one side of the nail and across the fingertip and parallel to the end of the nail. The physician will then drain the abscess. They might also insert a drainage tube.