CPT 10060 Question

[mjointer]

A patient presents to office with Hidradenitis cysts x 2 on axilla. I need to know if 10060 should be billed x2 with modifier 59 on the second line item or should 10061 be billed x1 since it's more than one cyst being treated?

 

[chembree]

10060 is incision and drainage. Drainage means the device was left in place to continually drain. Is this what you did in the office?

What was the approach? Was it an incision or percutaneous (direct puncture)?

If percutaneous I would use 10030 for a drainage or 10160 for an aspiration (the needle/catheter was removed and not left in place). If it is an aspiration guidance may be coded separately.

Each cyst is considered a separate site.

 

[chamberst]

10060 - description does not state that device was left in place to continually drain. Please see description below this is taken from Encoder Pro directly.

10060 Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single


The physician makes a small incision through the skin overlying an abscess for incision and drainage (e.g., carbuncle, cyst, furuncle, paronychia, hidradenitis). The abscess or cyst is opened with a surgical instrument, allowing the contents to drain. The lesion may be curetted and irrigated. The physician leaves the surgical wound open to allow for continued drainage or the physician may place a Penrose latex drain or gauze strip packing to allow continued drainage. Report 10060 for incision and drainage of a simple or single abscess. Report 10061 for complex or multiple cysts. Complex or multiple cysts may require surgical closure at a later date.

Since there is multiple I would use the 10061

 

[chembree]

Thank you. I have encoderpro and love it. It is a great resource. However, the AMA has defined a drainage procedure as the catheter being left in place.

This CSI article does a great job of explaining the difference in terminology of aspiration and drainage. Hope it helps clear up the confusion for you.

http://codingstrategies.com/blog/it-aspiration-or-drainage

Also, if you have access, you may also look in the Summer 2014 issue of Clinical Examples in Radiology, published by the ACR/AMA which is authoritative guidance. This is where you find guidance from the AMA that to qualify as a drainage, a catheter must be left in place.