# Incision and Drainage Procedure - Patient had an I&D done



## JulesofColorado

Patient had an I&D done of the right middle finger. Patient was prepped and cleansed with Betadine and alcohol and a #11 blade was used to make a superficial incision. Scant to small amount of purulent drainage was obtained and sent for culture and sensitivity.

I've tried every which way to find the ICD-9 and CPT code for this but I am not sure which to use.

Help!

Thank you


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## ARCPC9491

What about 10060?

Finger abscess is 681.00


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## coder21

Those are the two codes I would use.


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## vdelucci

I&D of finger is 26010-Simple 26011 for Complicated (EG: Felon)


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## ARCPC9491

I disagree with 26010 based on the documentation provided. 

26010 goes to the subcutaneous tissue, requiring debridement & irrigation.  

The note says "superficial" which is on the surface of the skin. 10060 is appropriate.


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## JulesofColorado

I think I'll go with 10060, it makes the most sense to me. Thank you!


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## LTibbetts

I agree with the 10060. It does say "superficial" in your brief procedure note. If the provider went into subcutaneous tissue, they most likely would have documented it. Remember, you can only code what is documented so go with what you've got. 
And also, never code something you might be unsure of. You can always query the provider for additional info if needed. Good luck!


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## ahinman

I realize this question is old news but I was wondering why some are opposed to the 26010 CPT?  I use this for my finger abscesses and nowhere in the CPT Book can I find that for this code it has to be subcutaneous.  I then looked it up in the Ingeix coders desk reference and it says that "the physician drains an abscess located on a finger.  In 26010, the physician lances an abscess in the cutaneous tissue of a finger."  So then the definition of cutaneous according to my Taber's Medical Dictionary is "Pert. to the skin."

So by using 26010 I feel that you are coding to the highest specificity available to you by your CPT.


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## Lisa Bledsoe

*Very interesting*

I've always used 10060-10061 but based on the descriptions of these codes and the description of 26010-20611 in CDR and looking at RVU's; why wouldn't one use 26010-26011??


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## diamonddiva

I would agree with CPT 10060. This is an integumentary code vs  CPT 26010 which is muskuloskeletal referring more to bone.


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## acbarnes

10060-10061 codes are Integumentray (Skin) codes and 26010-20611 are Musculoskeletal codes. Usually the 2000 codes are reserved for deep (below fascia to muscle) procedures. 

Anna Barnes, CPC, CGSCS


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## Lisa Bledsoe

Plain English Description for 26010-26011 according to _*Plain English Descriptions for Procedures*_ published by Contexo states "The physician drains an abscess from one of the fingers.  The physician makes an incision into the infected area and manipulates the abscess to drain it.  Code 26011 for an abscess that penetrates deep into the soft tissue of the finger, and requires more extensive work to remove the fluid and clean the wound".  

Doesn't appear to have anything to do with bone...


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## syb9161

*Human Anatomy*

We are educated and trained to code to the highest specificity.  Simply put the major most significant reason why the procedure is being done. 

Cutaneous – means skin (superficial) 

Subcutaneous- means below the skin (thick, fat-containing tissue)

(CPT code 26010) – Tell the location of the human anatomy, as well as what procedure is done.  This is more appropriate to use, because of a more significant code. You also, can add one of the modifiers FA thru F9 for hand.

(CPT code 10060) – Only tell what procedure is being done. This code is not specific enough. When there is a more detailed code that tells location of the human anatomy as well as what procedure. 

Shirley Burch, CPC


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## Ann Waters

I am doing a power point on I & D, Biopsy and Aspirations...I appreciate all of the information that you have given regarding why one would use the 10060 vs 26010. Key words, superficial and Integumentary vs Musculoskeletal  system. I am only at the beginning stage of making this powerpoint and just wanted to say I am grateful for this forum to use as a go to for some of the information.
Thanks,
Ann


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## surgonc87

I agree with 26010..it only has around 1 RVU higher and its more specific to the finger1)

MS


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