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Breast Abscess Re-drained w/out incision

  1. #1
    Question Breast Abscess Re-drained w/out incision
    Medical Coding Books
    Need some reassurance: physican performed incision and drainage on breast abscess 19020-patient presents back 16 days later with recurrent abscess. Physician removes steri strips to open the previous site and proceeds to probe with q-tip, redrain, irrigate and pack site. He did not perform another incision. I know he can not bill I&D as he stated, I'm thinking at best he can bill an E&M even though within global (she is not a Medicare patient). Am I on the right track?

  2. #2
    Any suggestions out there?

  3. Default
    It doesn't sound like a billable service. Patient is still in global and it doesn't sound like you can justify mod -78 on a procedure because patient wasn't taken to the OR or CMS certified procedure room. If you can justify Mod -78, I'd try an unlisted 19499. You also won't be able to justify Mod -24 on an E/M.

  4. #4
    Thank you, I felt the same.

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