pilonidal cyst vs. abscess

buckeye56

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I code for a billing company. The ED physician gave the dx as pilonidal abscess. He performed an I&D which included packing. If this were just any abscess, I would choose the CPT code 10061. If he had said pilonidal cyst, I would choose CPT code 10080 (I don't believe that 10081 applies since he did not mention primary closure, excision of tissue, or a Z-plasty). Is a pilonidal abscess the same as a pilonidal cyst? 10061 pays more than 10080, but which one is correct?
 

eadun2000

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I code for a billing company. The ED physician gave the dx as pilonidal abscess. He performed an I&D which included packing. If this were just any abscess, I would choose the CPT code 10061. If he had said pilonidal cyst, I would choose CPT code 10080 (I don't believe that 10081 applies since he did not mention primary closure, excision of tissue, or a Z-plasty). Is a pilonidal abscess the same as a pilonidal cyst? 10061 pays more than 10080, but which one is correct?
Yes, it is the same if it is either a pilonidial cyst or pilonidial abscess. You would use the 10080 in your situation instead of the 10081. Hope this helps.
 
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