Wiki Clarify the use of codes 10160 and 20000..

[elamathi]

How will you code for these scenarios:

a. Ovarian cyst aspiration using 19-Guage needle- I guess 10160 or 10022?
b. Ovarian cyst drainage using Catheter-20000 or 49021?

Both percutaneous and abdominal approach.

As per ACR Guidelines,

CPT code 20000 should be reported for drainage of an abscess or fluid collection, when no site specific code exists.

When a site-specific abscess drainage code is not applicable, CPT code 10160 should be reported for needle aspirations of abscess, hematoma, bulla, or cyst.

Code description for 10160 states
The physician performs a puncture aspiration of an abscess, hematoma, bulla, or cyst. The palpable collection of fluid is located subcutaneously. The physician cleanses the overlying skin and introduces a large bore needle on a syringe into the fluid space. The fluid is aspirated into the syringe, decompressing the fluid space. A pressure dressing may be placed over the site. As per Medlearn, the code description for 10160 states fluid aspiration for subcutaneous fluid collections. Is that appropriate to report 10160 for ovarian cyst aspiration?

Code description for 20000 states- Incision of soft tissue abscess (eg.secondary to osteomyelitis); superficial. Is that appropriate to code 20000, when no site-specific code is available.

Any help with the coding is most appreciated.

 

[Mouf1818]

a. 10022 is for fine needle percutaneous aspiration with guidance. If the report doesn't say "fine needle" you cannot use this code-regardless of what size guage is used. So for this one, I would use 10160 plus your guidance code if they used guidance.

b. is this done percutaneously or through an incision? If done through an incision I would use either 58800 or 58805(depending on the approach). If it was done percutaneously, unfortunately there isn't yet a code that exists for a percutaneous ovarian cyst aspiration so you would have to use 10160 because this is the closest you can get. You wouldn't use 49021 because this is only for abscesses of the peritoneal (or abdomen).


cpt 20000 is for use when an incision is done of a soft tissue abscess, superficial....meaning this is on the skin.....so ovary definately wouldn't fall into this.


Do you code a lot of interventional procedures? If so, I would recommend the Interventional Radiology Coder book by MedLearn (it's a good reference for interventionals that I would highly recommend!)

Amber, CPC

 

[elamathi]

Thank you Amber