Otolaryngology Coding Alert

Reader Questions:

Which Modifier for Multiple I&D?

Question: Within the global of 10060, we have had to perform 10060 multiple times. Can I use modifier 58? Alabama Subscriber Answer: Assuming the ENT is performing the multiple incision and drainages (10060, Incision and drainage of abscess [e.g., carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia]; simple or single) in the office to drain the same cyst that keeps refilling, modifier 58 (Staged or related procedure or service by the same physician during the postoperative period) is appropriate. CPT 2008 extended the modifier to apply when the doctor only anticipated the possibility of surgery instead of planning it. When an I&D requires a return trip to the operating room, you would instead use modifier 78 (Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period). Each time you report 10060-58, a new 10-day global period starts. You would include all related care, such as the typical follow-up office visit, during this time in 10060. Enter the bundled E/M as 99024 (Postoperative follow-up visit, normally included in the surgical package, to indicate that an E/M service was performed during a postoperative period for a reason[s] related to the original procedure) at a $0 charge.
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