Wiki Repeat abscess drainage during post-op

[Kreismann]

Hi,

I have a question about repeat finger abscess drainage during the post-op period.

Patient was initially seen for a finger abscess which was drained under local anesthesia and packing was done. I used 26011 for the CPT.

Patient returned 2 days later and the abscess was drained again and packed under anesthesia. I coded it as 26011 again yet it got denied by Medicare.

Should the follow-up be included in the initial procedure or is there another code?

Any help is appreciated.

Kristi

 

[Mojo]

Was another incision made? If not, the second visit would not meet the description of an incision and drainage. If another incision was performed, does your documentation support the use of modifier 58 appended to the second procedure?

Staged or Related Procedure or Service by the Same Physician During the Postoperative Period: The physician may need to indicate that the performance of a procedure or service during the postoperative period was (a) planned prospectively at the time of the original procedure; (b) more extensive than the original procedure; or (c) for therapy following a diagnostic surgical procedure.

 

[Kreismann]

Thank you!