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hidradenitis 11450 vs 10060

  1. #1
    Default hidradenitis 11450 vs 10060
    Medical Coding Books
    If the physician does two excisions- one on the inner arm-10 cm is excised and one on the outter arm- 6 cm is excised- then do I code 11450 twice? Or do I consider using 10060-10061 if he uses a JP drain- where that is covered under that code and can also be used for hidradenitis with a global incase the drain gets changed? Any ideas?

    Brooke Bierman, CPC, CPB
    Coding & Billing Manager
    2014 President AAPC Des Moines Chapter

  2. #2
    Milwaukee WI
    Default 11450
    For an accurate response to surgical coding questions, please post the scrubbed operative / procedure note.

    That being said ...
    11450 is a more extensive procedure than 10060-61. 11450 is billed unilateraly, so if he treated both axillae, you would use the -50 modifier. The drain will be included in 11450 (or 10061 if that is truly what was documented).

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. #3
    I'm sorry, I didn't have an actual Op Note. I was going off of another example someone else had said that JP Drains were usually performed with 10060 series versus the 11450 but both codes can be used for hidradenitis and I thought I saved it but now I can't find it. My intern brings me stuff to look at and I try to find the best explanation to give her when I really don't know the answers myself. I just figured a drain would make it more extensive to use the 11450 was all and was trying to get other opinions because I don't quite understand the difference between the two- aren't both codes really just cutting open the abscess and draining it? One is a 90 day global and the other a 10 day global... I have a general surgery book but I guess it basically says 11450 is strictly for hidradenitis and it doesn't give an excision diameter like the other codes in the 11400-series. It looks like 10 cm would be a good size incision compared to an I&D.

    Brooke Bierman, CPC, CPB
    Coding & Billing Manager
    2014 President AAPC Des Moines Chapter

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