AAPC - Back to school
Results 1 to 3 of 3

Thread: I & D of Hand

  1. #1
    Join Date
    Apr 2007
    Daytona Beach, FL

    Exclamation I & D of Hand

    AAPC: Back to School
    Is there a code for an I&D of the metacarpals or would I have to use 10140? Can someone review the following surgical note from Ortho and let me know if there is a better CPT code to use?

    PREOP DIAGNOSIS: Infected right hand.

    POSTOP DIAGNOSIS: Infected hematoma of the right hand.

    PROCEDURE: Incision and drainage with irrigation of the right hand.

    Procedure was as follows: After the patient was anesthetized, the right upper extremity was prepped and draped in the usual sterile fashion. Tourniquet was applied but was not used throughout the procedure. At this time, after a time out to verify the patient, the laterality, antibiotics, etc., a longitudinal incision was made in the area of the 4th metacarpal and subsequently in the area of the second metacarpal. This was taken down subcutaneously. It was very edematous. On putting in a clamp to spread it a little bit, it became evident there was some pus. It was just a small amount but cultures and sensitivities were done. There was a small amount of pus also along the other one but it was minimal. Again, there was a lot of edema. The wounds were inspected. I did not see any more pus, even though I palpated the hand and actually pushed on it palmarly, as well as dorsally. It was therefore irrigated with gentamicin solution. The thenar eminence was then evaluated and it was still quite swollen. I was concerned that there might be a pocket of pus there, therefore, a small incision was made right over the muscle itself and the probe was just inserted without any evidence of any either hematoma or pus. This being the situation, all the wounds were copiously irrigated and closed using 4-0 Vicryl subcutaneously and 5-0 nylon for the skin. A Hemovac drain was inserted so as not to allow any more accumulation of a hematoma. At this time, the wounds were cleaned and dressed using bacitracin and Adaptic. A bulky dressing was applied. Anesthesia was reversed. The patient tolerated the procedure well and left the OR in good condition.

    Jodi Dibble, CPC

  2. #2
    Join Date
    Apr 2007


    I think 10140 is the best code for the procedure performed. Depending on the carrier, it might warrant appending modifier 22 since it seems to have been more extensive than just an I&D.

    If this was a postoperative wound then 10180 might be the code to use in this case.

  3. #3
    Join Date
    Apr 2007
    Daytona Beach, FL


    Thanks Susan for your help.

    I thought that was what I had to use but I was hoping I was missing something and there was another code. This was not post op either.

    Thanks again!
    Jodi Dibble, CPC

Similar Threads

  1. I&D of hand
    By Emmalia in forum Orthopaedics
    Replies: 0
    Last Post: 02-19-2013, 06:44 AM
  2. I&D Granuloma Hand
    By cwilson3333 in forum Orthopaedics
    Replies: 0
    Last Post: 12-01-2011, 08:11 AM
  3. I & D of hematoma of hand
    By codedog in forum Orthopaedics
    Replies: 2
    Last Post: 06-24-2010, 03:22 PM
  4. I & D Dorsum of Hand
    By kibbit99 in forum Orthopaedics
    Replies: 1
    Last Post: 09-21-2009, 08:16 AM
  5. hand help please
    By Justarose in forum Outpatient Facilities
    Replies: 3
    Last Post: 06-15-2009, 12:14 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.