Question I&D with debridement of abscess of preauricular area and excision of fistula tract

wynonna

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Hinsdale, MA
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MD does I&D of preauricular infected inclusion cyst. He debrides abscess and excises fistula tract.
I&D and debridement of abscess
There is a right preauricular fistula with abscess which is infected. He performs a modified parotidectomy incision.
A squamous epithelium tract is excised.
Incision is closed with Vicryl for subdermis.

What would the CPT codes be?
thank you
 

jackjones62

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No, I would not use either, 69005 refers to the I/D of an external ear abscess and 21555 is a neck procedure. Barbara Cobuzzi and I had a difference of opinion about a similar situation last year. She referenced using 42810 or 42815 but those were excisions of branchial cleft cysts and they are different than preauricular cysts. Was this procedure done in the OR? with nerve monitoring? or in the office? It most of these situations you cannot bill for the I/D as it gets bundled with the excision of the cyst and tract. If you could provide more details, simple closure, layered closure, etc. I understand the approach.

Jennifer
Coding Analyst
 
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