Ob-Gyn Coding Alert

Question: My ob-gyn saw a patient who had pus in the breast and did an incision and drainage (I&D). What are the CPT codes for a breast smear and a breast culture?

Florida Subscriber

Answer: You will not be reporting the culture or smear. The lab will choose which lab code to use based on the type of culture the ob-gyn orders. You can find the different kinds listed in the CPT index under "culture." The ob-gyn would indicate the lab test he wants performed on the sample he provides. You will, however, report a procedure code for the I&D. The ob-gyn did this to relieve the problem and collect the specimen.

For instance, you might report the I&D with 19020 (Mastotomy with exploration or drainage of abscess, deep)

-- if that represents the amount of work your ob-gyn performed. You might consider appending modifier 52 (Reduced services) if your ob-gyn did less extensive work. This code has 11.26 relative value units (RVUs) in the office setting.

Another option is 10060 (Incision and drainage of abscess [e.g., carbuncle, supprative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia; simple or single]) if the I&D occurred at the skin surface.